Liver Percussion

How to Perform

With the patient supine, expose the right lower chest and upper abdomen while keeping the remainder of the chest draped. If breast tissue overlies the right midclavicular line, ask the patient to lift the right breast superiorly as needed to expose the chest wall. Along the right midclavicular line, percuss downward from the resonant lung until the note becomes dull, marking the upper border of liver dullness. Then percuss upward from a tympanitic area of the abdomen until the note becomes dull, marking the lower border. Measure the vertical distance between the two marks to estimate the liver span.

How to Interpret