Liver size in normal subjects as estimated by percussion

ABSTRACT

Clinical estimation of liver size is of daily practical value. Three hundred forty normal adult volunteers [244 males and 96 females] were examined for liver size by percussion. Mean liver span in the mid-clavicular line was greater in males than females and related most significantly to the height of the subject. Liver span also correlated significantly with age and lean body mass in males but not females. A normogram was derived predicting the expected range of liver dullness from the height of the subject, thus providing a reference table useful in the estimation of liver size by percussion. Clinical estimation of liver size is of daily practical value for determining whether it lies within the normal range or whether hepatomegaly exists. The common practice for the clinical estimation of liver size is measurement of the projection of its lower border below the right costal margin. However, a poor correlation has been found between this method and liver size assesed by scintiscans or radiography[12]. Percussion of the upper and lower border of the liver has been reported to be a more accurate method of assessing liver size[1-3], and has been used in estimating the liver size of normal subjects[4,5]. The present investigation was carried out to a] study the liver size by percussion of its upper and lower borders in the mid-clavicular line in healthy adults and, b] to look for a relationship between the liver size and the age, sex, weight, height and lean body mass of the subjects. The resultant normal values obtained may thus provide reference data useful in the clinical estimation of hepatomegaly