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Simultaneous Percussion Auscultation Technique for the Determination of Liver Span

Charles W. Callahan Jr, MC, USAR
Arch Pediatr Adolesc Med. 1994;148(8):873-875. doi:10.1001/archpedi.1994.02170080103020.
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The assessment of liver size is an aspect of the pediatric physical examination that has application for the general pediatrician as well as for other pediatric subspecialists. Estimates of liver size in pediatric patients are often based on the distance of the liver edge below the right costal margin. This estimate does not, however, reflect the liver span in healthy children, much less children with hyperinflated lungs.1

A recent survey of patients hospitalized in our institution assessed the documentation of liver size on the admission history and physical examination (C.C., unpublished data, April 1993). The medical records of 90 patients (age range, 4 days to 22 years) were reviewed. In 50 (55%) of the 90 cases, the only comment about liver size was the absence of hepatomegaly; in 29 (32%) of the 90 cases there was no mention of the liver examination; and in nine (10%) of the 90


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