examination (spleen)

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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:

  • palpation
  • 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 07/2021

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