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The spleen enlarges inferiorly and medially from the left costal margin across the umbilicus to the right iliac fossa.
Physical examination is by:
- percussion - over the spleen, the percussion note is dull
- auscultation - rarely, revealing a friction rub
In differentiating the spleen from an enlarged left kidney or a mass at the splenic flexure, note that:
- the spleen has no palpable upper border
- the spleen is not ballottable except in the presence of gross ascites
Last reviewed 10/2020