Detection of the Liver Below the Costal Margin: Comparative Value of Palpation, Light Percussion, and Auscultatory Percussion

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The comparative value of palpation, light percussion, and auscultatory percussion for detecting the liver below costal margin was studied in 45 normal subjects and 20 patients. The presence of the liver 2 cm or more below the costal margin was considered abnormal, since this organ was found no more than 1 cm below in a few normal subjects only by auscultatory percussion. In the patient group, auscultatory percussion detected the liver of 12; four livers and one case of gallbladder-hydrops were detected only by this method. Also, auscultation behind the right flank during percussion identified one hydronephrotic kidney. The liver was detected by palpation in 12 patients and was found only by this method in 6 of them. Light percussion detected the liver in only 6 patients, but was useful in 2 for determining that the liver dome had been depressed in the rib cage. Results of liver function tests were abnormal in 15. These findings suggest that these methods were valuable for detecting liver diseases in patients.

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