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Palpatory estimation of liver size. Within- and between-observer variation.
Acta Chirurgica Scandinavica
|January 1, 1979
Summary
Palpating liver size shows significant variation among surgeons, impacting clinical decisions. Relying on this physical exam finding alone is not recommended for accurate liver assessment.
Area of Science:
- Hepatology
- Surgical Assessment
- Medical Diagnostics
Background:
- Accurate assessment of liver size is crucial for diagnosing various medical conditions.
- Palpation is a common method used by clinicians to estimate liver dimensions.
Purpose of the Study:
- To evaluate the reliability of liver size estimation through palpation.
- To determine the degree of variation in palpation accuracy among surgeons with different experience levels.
Main Methods:
- Twenty-three patients were included in the study.
- Fourteen surgeons (senior and junior) estimated liver size by measuring the distance from the thoracic cage to the liver's lower border.
- Measurements were taken along the midclavicular and midsternal lines under blindfold conditions.
Main Results:
- Substantial within-observer and between-observer variation was observed in liver size measurements.
- The accuracy of palpation varied significantly among the participating surgeons.
Conclusions:
- Palpation alone is an unreliable method for accurately determining liver size.
- Clinical decisions should not heavily depend on the palpatory estimate of liver size due to significant variability.