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To rule out an enlarged spleen, a pretest probability of 30% or less will yield a negative predictive value over 90% (calculation) Given the paucity of physical exam findings to evaluate possible splenomegaly, Castell's sign is the most sensitive, and is thus a good tool to teach in an advanced-type physical diagnosis course.
Splenomegaly is an enlargement of the spleen. [1] The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen.Splenomegaly is one of the four cardinal signs of hypersplenism which include: some reduction in number of circulating blood cells affecting granulocytes, erythrocytes or platelets in any combination; a compensatory proliferative response in the bone marrow; and the ...
Spleen: Splenomegaly: Medical imaging: Largest dimension of over 11 cm, [27] [28] or craniocaudal height of 13 [29] cm. Moderate splenomegaly: the largest dimension is between 11–20 cm [27] Severe splenomegaly: the largest dimension is greater than 20 cm [27] Autopsy: Weight over upper limit of standard reference range, of 230 g (8.1 oz) [12 ...
An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity (including the liver, spleen, large or small intestines), or simply as a part of a complete physical examination for other conditions. In a complete physical examination, the abdominal exam classically follows the ...
Assessing dullness to percussion may be more difficult in obese patients. A 1993 systematic review by The Rational Clinical Examination found that, as a test for splenomegaly, percussion over Traube's space yields a sensitivity and specificity of 62% and 72%, respectively. [2] Specificity may be higher if the patient has not eaten in the last ...
A thorough cardiopulmonary exam including auscultation of the heart and lungs can help evaluate for cardiac shunting or chronic pulmonary disease. An abdominal exam can assess for splenomegaly, which can be seen in polycythemia vera. Examination of digits for erythromelalgia, clubbing or cyanosis can help assess for chronic hypoxia. [12]
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Fever is the most common symptom of splenic abscess, followed by abdominal pain and a tender mass on palpation of the left upper quadrant of the abdomen. The common signs and symptoms described of a splenic abscess include the triad of fever, left upper quadrant tenderness, and leukocytosis is present only in one-third of the cases.