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Screenings by age and gender

Enlarged liver seen by chance on a scan

An ultrasound, CT or MRI done for something else may mention "hepatomegaly", a "mildly enlarged liver" or "liver at the upper limit of normal size". The liver is the largest organ inside the body; it helps digest food, store energy and remove poisons. (MedlinePlus) This page covers what the report means, why normal size varies and which signs need help, not treatment.

What the report means

  • Hepatomegaly. The medical word for an enlarged liver. A review says it should lead doctors to think about a wide range of causes. (Jerves Serrano 2024)
  • How it is measured. Reports usually give one length in centimetres. A common rule treats up to about 16 cm, measured down a line through the middle of the right collarbone, as normal. (Kratzer 2003)(Seppelt 2022) CT or MRI can also measure the whole volume. (Kim 2021)
  • No symptoms is common. Most types of liver disease cause no symptoms in the early stages. (NHS)(MedlinePlus)
  • Fat or spots in the liver are different. A fatty liver and a spot or lump inside the liver have their own pages: fatty liver seen by chance and liver lesion found by chance.

Why normal size varies with body size, sex and age

  • Body size and sex. In an ultrasound survey of 2,080 adults aged 18 to 88, the average liver length was 14.0 cm (14.5 cm in men and 13.5 cm in women). Body mass index and height mattered most, with sex and age also playing a part. 11.5% had a liver longer than 16 cm. (Kratzer 2003)
  • Age. In a German MRI study of 1,939 adults, the front to back size of the liver rose with age and body mass index, while liver volume seemed to fall with age. Men had larger livers than women. (Seppelt 2022)
  • One measurement is rough. The same study found a single length did not predict the true liver volume well. (Seppelt 2022) A CT study of 2,989 healthy adults gave a usual volume range of about 825 to 1,700 cm³ and offered personal ranges by age, sex, height and weight. (Kim 2021)

Common causes listed in guidance

Which checks are usually done next

  • Questions and blood tests. For a possible fatty liver, the NHS says the GP asks about symptoms, checks height, weight and waist, asks about alcohol, and may arrange more blood tests and sometimes an ultrasound. (NHS fatty liver) See liver function test results.
  • Common causes first. A review says common causes are looked for first, before rare ones. (Jerves Serrano 2024)
  • Scarring tests. For people with a fatty liver linked to metabolic health (MASLD), NICE says to offer testing for advanced scarring (fibrosis), to consider an ELF blood test for it, and not to use routine liver blood tests on their own to judge scarring. (NICE NG49) Other guidance uses a FIB-4 score first: see fatty liver screening: the FIB-4 score.
  • Worry is real. See after an abnormal screening result.

How it ties to your age-based checks

A scan that shows an enlarged liver is a good moment to make sure your routine checks are up to date:

Who it applies to

Adults told that an ultrasound, CT or MRI done for another reason shows an enlarged liver. Children, people already known to have a liver condition, and a spot or lump inside the liver are outside this page.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if your skin or the whites of your eyes look yellow (jaundice), sometimes with itchy skin, darker pee and paler poo. (NHS jaundice) For people with cirrhosis, it says to call 999 or go to A&E (call 911 in the US) if they are vomiting blood, their poo is very dark or black, or they suddenly become confused or have slurred speech. (NHS cirrhosis) See a GP if you think you might have liver disease. (NHS)

Routine age-based screening

An enlarged liver on a scan does not replace the routine screenings for your age. See screenings by age and gender.

Where they differ:

  • Which cut-off. A common rule treats a liver over 16 cm as enlarged. (Kratzer 2003) A large MRI study says that rule has not been well proven and suggests 17 cm measured front to back, adjusted for sex, age and body mass index. (Seppelt 2022)
  • Length or volume. One length is quick but does not predict liver volume well (Seppelt 2022); a CT study proposes volume ranges personalised by age, sex, height and weight. (Kim 2021)
  • Which scarring test. NICE names the ELF test for people with MASLD (NICE NG49), while other guidance starts with a FIB-4 score (see fatty liver screening: the FIB-4 score).

Your doctor decides what your result means for you.

Questions people ask

What size is an enlarged liver?

A common rule is that a liver up to about 16 cm long, measured down a line through the middle of the right collarbone, is normal, but a large MRI study says this rule has not been well proven and suggests 17 cm front to back as the upper limit instead. (Seppelt 2022)

How many healthy people are over the usual limit?

In an ultrasound survey of 2,080 adults, 11.5% had a liver longer than 16 cm. Body mass index and height mattered most for liver size. (Kratzer 2003)

What can make the liver bigger?

Guidance and reviews list fatty liver, regular heavy drinking, hepatitis, inherited conditions such as haemochromatosis, heart failure or a blood clot, blood conditions such as leukaemia or lymphoma, and other inflammatory or infiltrative conditions. Common causes are looked for first. (NHS) (Jerves Serrano 2024)

What checks usually come next?

The NHS says a GP may arrange more blood tests and sometimes scans such as an ultrasound. MedlinePlus says imaging tests and liver function tests can check for liver damage. Your doctor decides which checks you need. (NHS fatty liver) (MedlinePlus)

When should I get help quickly?

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if your skin or the whites of your eyes look yellow. For people with cirrhosis, it says to call 999 or go to A&E (call 911 in the US) for vomiting blood, very dark or black poo, or sudden confusion or slurred speech. (NHS jaundice) (NHS cirrhosis)

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