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Percussion and palpation of the spleen
Last reviewed: 19.10.2021
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[Technique of the percussion and palpation of the spleen
One of the most traditional methods is the topographic percussion of the spleen according to Kurlov, which is carried out in the position of the patient lying down with an incomplete turn to the right side. Percussion is performed on the 10th intercostal space, starting from the spine; on the boundaries of blunting determine the longitudinal size (length) of the spleen, which in healthy individuals, as a rule, does not exceed 8 cm.
It should be noted that the accuracy of the percutaneous determination of the size of the spleen is small, and this is due to the peculiarities of its anatomical location, the proximity of the hollow organs (stomach, colon), which can substantially distort the results of the study.
Palpation of the spleen is carried out according to the general rules of deep gliding topography palpation in the patient's position on the right side with straightened right and slightly bent in the hip and knee joints with the left foot.
Normal performance
In the event that the spleen protrudes from under the rib margin, which can be observed either when it is enlarged or when it is dropped, the length of the protruding part is taken into account separately. The width (diameter) of the spleen (normal to 5 cm) is determined by percussion from above from the anterior axillary line towards the back axillary line. The obtained results are expressed in the form of a fraction, in the numerator of which the length is indicated, and in the denominator the width of the spleen. Normally, the spleen is located most often between the IX and XI ribs.
With a deep inspiration, the enlarged spleen descends and "rolls" through the fingers of the investigator. With a significant increase in the spleen, its lower edge descends to the left hypochondrium, in this case it is possible to probe the surface of the spleen, its characteristic incision, to determine its consistency and soreness. Normally, the spleen is not palpable.