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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.
Light percussion may be used to confirm lack of extension of the liver edge below the costal margin and/or guide further palpation. Low probability of disease, liver edge palpable: With a palpable lower edge, MCL span can be ascertained by light percussion of the upper border.
Hepatomegaly can represent intrinsic liver disease or may be the presenting physical finding of a generalized disorder. It is important to realize that the liver is easily palpated in most children at 1-2 cm below the right costal margin. A normal liver should feel soft and is easily moveable upon inspiration.
The probability that the liver edge can be felt below the right costal margin is about 50%. However, this does not correlate with the liver span in normal patients. Thus, the prior probability of hepatomegaly depends entirely on the possible underlying disease states.
We could palpate the liver about 3 cm be- low the costal margin and also palpate the spleen about 2 cm below the left costal margin on abdominal examination (Fig. 2). There was no...
The mean +/- SD distance of the liver edge below the costal margin was 3.0 +/- 0.7 cm, with a normal range from 1.6 to 4.4 cm. According to our results, we recommend investigation for hepatomegaly when the liver is palpated more than 4.4 cm below the costal margin.
Among the subjects with a steep slope of the liver edge there was an about even distribution in the downward extension of the liver, reaching 1, 2, 3 and 4 fingerbreadths below the costal...
