LSU Physician Champions - Dr. Daniel Raines and Dr. Kellen Jex
Palpation of the Size of the Liver
The exam should be begin with the patient supine, and the abdomen exposed. Begin to palpate the abdomen in the right lower quadrant.
Asking the patient to take a deep breath during palpation can sometimes assist in palpating the liver edge. One will feel the edge of the liver “roll over” the fingers
if it is palpable. Palpation should slowly progress cephalad until the costal margin is reached.
If palpation is not successful, the size of the liver may be percussed. Start to percuss the right chest in the midclavicular line,
beginning in the approximate area of the third intercostal space. Light percussion should progress caudad until dullness is noted, which represents
the upper liver edge. Resume percussion in the right lower quadrant, in the midclavicular line, in an area that is tympanic and progress cephalad.
Dullness to percussion denotes the lower liver margin.