Tests and diagnosis

By Mayo Clinic Staff

An enlarged liver may go unnoticed for a long time. Frequently, liver enlargement isn't discovered until you see a doctor for more-obvious signs and symptoms of the condition responsible for your enlarged liver.

As part of the physical examination for possible liver disease, doctors use their fingertips to press on the right side of your belly just below your rib cage and feel (palpate) the lower edge of your liver, noting its size, texture, and tenderness. Depending on the underlying cause, an enlarged liver may feel soft, firm or irregular. Well-defined lumps may be present as well.

This exam provides only a very rough estimate of liver size, though. For a precise measurement, you'll need imaging, typically starting with an abdominal ultrasound. If there's a need for more-detailed images, you may also have a computerized tomography (CT) scan or magnetic resonance imaging (MRI).

Additional procedures

Once your doctor determines that you have an enlarged liver, further tests help determine the cause. These tests include:

  • Blood tests. A blood sample is tested to determine liver enzyme levels. This can give clues about the health of your liver. Blood tests can also identify viruses that can cause enlarged liver, such as the hepatitis viruses.
  • Magnetic resonance elastography uses shear waves to create a visual map (elastogram) of the stiffness of liver tissue. This test is noninvasive and can be an alternative to a liver biopsy.
  • Removing a sample of liver tissue for testing (liver biopsy). Your doctor may recommend a biopsy to collect a sample of liver tissue for laboratory testing. A liver biopsy is often done using a long, thin needle that's inserted through your skin and into your liver. The needle draws out a core of tissue that is then sent to a laboratory for testing. Your doctor may use ultrasound to help guide the biopsy.
Nov. 27, 2015