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Percussion of the liver
Last reviewed: 06.07.2025
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Percussion of the liver is part of a comprehensive study of the liver and gallbladder and allows one to get an idea of the size of the liver, an increase in which primarily causes a shift in the lower border, and only in rare cases (abscess, large cyst, large tumor node) - its upper border.
The upper border of the liver usually coincides with the border of the lower edge of the right lung, the lower border corresponds to the lower edge of the liver, percussion determination of the location of which helps to further palpate the liver.
Percussion of the lower border of the liver is quiet, starting from the area of tympanic sound at the level of the navel or below, then the pleximeter finger is moved upward until an absolute dull sound appears. The size of the liver (absolute dullness), determined by percussion according to Kurlov, corresponds to 9 cm along the right midclavicular line, 8 cm along the midline, 7 cm along the left edge of the costal arch; if the liver is enlarged, the first large size is indicated by a fraction, the numerator of which is the total size along the right midclavicular line, and the denominator is that part of it that corresponds to the size extending downwards beyond the costal arch. Normally, the lower edge of the liver along the right midclavicular line is not determined by percussion. With a deep breath and in a vertical position, the lower border of the liver shifts downward by 1-1.5 cm.
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