CLINICAL DIAGNOSTIC MANUAL
Soft but non-tender hepatomegaly refers to an enlargement of the liver that does not cause pain when palpated. This sign can be associated with a variety of chronic and systemic conditions affecting the liver.
Non-tender hepatomegaly often indicates chronic or infiltrative liver diseases that cause a gradual increase in liver size without acute inflammation. Accurate diagnosis and management require a thorough clinical evaluation and the use of various complementary tests.
Condition | Symptoms and Clinical Signs | Suspected Diagnosis | Confirmatory Diagnosis |
Cirrhosis | Hepatomegaly, jaundice, ascites, oesophageal varices, hepatic encephalopathy, fatigue, weight loss, spider angiomas, palmar erythema | Clinical history, clinical symptoms | Liver function tests, abdominal ultrasound, liver biopsy |
Lymphoma | Hepatomegaly, fever, night sweats, weight loss, fatigue, lymphadenopathy, splenomegaly | Clinical history, clinical symptoms | Lymph node biopsy, abdominal CT/MRI, haematological tests |
Leukaemia | Hepatomegaly, fatigue, fever, pallor, bruising, petechiae, recurrent infections, lymphadenopathy, splenomegaly | Clinical history, clinical symptoms | Complete blood count, bone marrow aspiration/biopsy |
Haemochromatosis | Hepatomegaly, fatigue, arthralgias, diabetes mellitus, skin hyperpigmentation, loss of libido, heart failure | Clinical history, clinical symptoms | Iron overload test, ferritin levels, liver biopsy |
Primary biliary cirrhosis | Hepatomegaly, pruritus, jaundice, fatigue, xanthomas, xanthelasmas, skin hyperpigmentation | Clinical history, clinical symptoms | Liver function tests, autoantibodies, liver biopsy |
Amyloidosis | Hepatomegaly, fatigue, weight loss, oedema, peripheral neuropathy, macroglossia, carpal tunnel syndrome | Clinical history, clinical symptoms | Affected tissue biopsy, serum protein electrophoresis |
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