Physical examination of the liver: does it make sense in the third millennium?

Palpation is a crucial tactile examination method for assessing abdominal organs and detecting conditions like tenderness, distention, masses, or fluid. It involves both light and deep palpation techniques, each serving specific diagnostic purposes. Light palpation helps identify tenderness and other surface-level indicators, while deep palpation locates and assess abdominal masses and organ boundaries. A skilled professional can gather valuable insights through palpation, including evaluating...

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...

The liver, the largest gland within the human body, is a firm and reddish-brown organ. This wedge-shaped structure weighs approximately 1.5 kg and occupies a significant portion of the right hypochondriac and epigastric regions. It extends more to the right of the body's midline than to the left.
Located under the diaphragm, the liver is almost entirely ensconced within the rib cage, providing it with substantial protection. Except for the superior most bare area, the liver's surface is covered...

The microscopic anatomy of the liver is a complex and intricate system that comprises numerous structural units known as liver lobules, each of which is comparable in size to a sesame seed. These hexagonal structures consist of plates of liver cells or hepatocytes, which are characterized by their versatility and abundance of cellular apparatus like rough and smooth ER, Golgi apparatus, peroxisomes, and mitochondria.
Hepatocytes perform a variety of essential functions. They secrete...

Percussion is a fundamental technique used to assess the liver, spleen, and abdominal organs by tapping the abdomen and interpreting the resulting sounds. This method helps identify fluid, distention, and masses through variations in sound, such as the high-pitched tympany of air-filled areas and the dullness of solid masses. Understanding how to percuss these organs provides valuable information for healthcare professionals in diagnosing conditions early.
Percussion
Percussion is an essential...

Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):