RT Journal
A1 Castell D
T1 HOw big is the normal liver, indeed!
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1979
FD September 1
VO 139
IS 9
SP 968
OP 969
DO 10.1001/archinte.1979.03630460012006
UL http://dx.doi.org/10.1001/archinte.1979.03630460012006
AB Hepatomegaly was once considered to be present if the examiner could feel the edge of the liver below the right costal margin, a physical finding that probably depended more on a change in the consistency of the liver than the actual overall increase in size. Thus, patients with the firm fibrotic liver secondary to alcoholic cirrhosis were often described as having hepatomegaly, even though the pathologic specimen might show a fibrotic shrunken liver. The art of physical examination of the liver was further developed by the appreciation that estimating liver size by percussion in the midclavicular line was a more reliable method of predicting the actual liver mass.1 This art was further expanded by a careful clinical study that attempted to establish reasonable values for the normal range of hepatic illness based on percussion in a number of normal individuals.2 In that study, the area of liver dullness