Soft and Tender Hepatomegaly

CLINICAL DIAGNOSTIC MANUAL

Soft and tender hepatomegaly refers to the enlargement of the liver accompanied by tenderness or pain when pressure is applied during physical examination. This clinical sign may indicate various hepatic and systemic conditions.

Hepatomegaly can result from inflammation, congestion, or infiltration of the liver, and its detection and evaluation are crucial for determining the underlying cause and establishing appropriate treatment.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Alcoholic hepatitis	Right upper quadrant pain and tenderness, jaundice, fatigue, loss of appetite, nausea, vomiting, fever, ascites	History of alcohol consumption, clinical symptoms	Liver function tests, abdominal ultrasound, liver biopsy
Infectious hepatitis	Right upper quadrant pain, jaundice, fatigue, nausea, vomiting, loss of appetite, fever, dark urine, pale stools	Clinical history, clinical symptoms	Liver function tests, viral serologies, abdominal ultrasound
Infectious mononucleosis	Right upper quadrant pain, fever, pharyngitis, lymphadenopathy, severe fatigue, occasional jaundice, splenomegaly	Clinical history, clinical symptoms	Epstein-Barr virus serology, complete blood count, abdominal ultrasound
Right-sided heart failure	Right upper quadrant pain and tenderness, peripheral oedema, dyspnoea, ascites, jugular venous distension, fatigue, weight gain	Clinical history, physical examination, signs of heart failure	ECG, echocardiogram, liver function tests
Tricuspid regurgitation with right-sided heart failure	Right upper quadrant pain and tenderness, peripheral oedema, ascites, dyspnoea, jugular venous distension, fatigue, palpable hepatic pulse	Clinical history, physical examination, signs of heart failure	ECG, echocardiogram, liver function tests