TABLE 912 Liver Enlargement Apparent and Real

O A palpable liver does not necessarily indicate hepatomegaly (an enlarged liver), but more often results from a change in

2 consistency—from the normal softness to an abnormal firmness or hardness, as in cirrhosis. Clinical estimates of liver size z should be based on both percussion and palpation, although even then they are far from perfect.

Upper-

border low

Height by -

percussion normal

Downward Displacement of the Liver by a Low Diaphragm

This is a common finding (e.g., in emphysema) when the diaphragm is low. The liver edge may be readily palpable well below the costal margin. Percussion, however, reveals a low upper edge also, and the vertical span of the liver is normal.

Elongated right lobe

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