Splenomegaly physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Physical Examination

Abdomen

In young patients, splenomegaly can be assessed by turning the patient on the right side in order to have the spleen falling downwards. In this position, the spleen should not be palpable under normal conditions. Start from below to look for splenomegaly. Rule out a palpable kidney by ballottement by bimanual palpation. A palpable spleen indicates that its size is increased by at least two-fold. Spleen is said to be moderately enlarged when it is more than 2-4 finger breath or 4-8cm from the costal margin. In adolescent and adult patients, mild splenomegaly may only be detected by abdominal imaging such as ultrasound.[1]

References

  1. Patterson, MC.; Hendriksz, CJ.; Walterfang, M.; Sedel, F.; Vanier, MT.; Wijburg, F.; Baumgartner, M.; Bembi, B.; Bonnot, C. (2012). "Recommendations for the diagnosis and management of Niemann-Pick disease type C: an update". Mol Genet Metab. 106 (3): 330–44. doi:10.1016/j.ymgme.2012.03.012. PMID 22572546. Unknown parameter |month= ignored (help)
  2. Grover SA, Barkun AN, Sackett DL (1993). "The rational clinical examination. Does this patient have splenomegaly?". JAMA. 270 (18): 2218–21. PMID 8411607. Ovid full text

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