Percussion pain in liver and gallbladder

Liver area and gallbladder licking pain is an auxiliary method used to check whether the abdomen is normal. Hepatic sputum pain has a certain significance for the diagnosis of hepatitis and liver abscess; the position of the gallbladder is deep, and the size can not be found by the method of percussion, but the gallbladder licking pain can help the diagnosis of cholecystitis. Through this examination, the lesion and the corresponding symptoms can be judged. In the hepatic area, the spleen is diagnosed in the spleen. When the spleen is not satisfied with palpation or there is little spleen in the rib, the spleen should be used to further examine the size of the spleen. Basic Information Specialist classification: Digestive examination classification: other examinations Applicable gender: whether men and women apply fasting: not fasting Tips: Try to cooperate with the doctor's examination. Normal value The anterior boundary of the normal spleen dull area does not exceed the anterior line of the sac, and the posterior boundary is separated from the dull area of ​​the kidney by the colon drum area. The voiced area of ​​the spleen is between the 9th and 11th ribs of the midline of the spleen, and its width is about 4 to 7 cm. Clinical significance Abnormalities in the liver area and gallbladder fistula: The spleen voiced area changed, and the spleen voiced area was enlarged to see splenomegaly caused by various reasons. Spleen dull sound area is seen in the left pneumothorax, gastric dilatation, tympanic and so on. Under pathological conditions, the up-and-down lung fibrosis was seen in right pulmonary fibrosis, right lower lung atelectasis, pneumoperitoneum and tympanic intestine; the liver dullness was found in emphysema, right tension pneumothorax, visceral drooping and so on. The dullness of the liver is seen in liver cancer, liver abscess, hepatitis, hepatic congestion, polycystic liver disease, etc.; under the armpit abscess, due to the liver down and the diaphragm, the liver dull area is also enlarged, but the liver itself does not increase. The dullness of the liver is found in acute hepatic necrosis, cirrhosis and flatulence. The disappearance of the dullness of the liver is replaced by the drum sound, which is caused by the covering of the liver surface. It is an important sign of acute gastrointestinal perforation. People who need to be examined: routine physical examination items, abnormal abdominals. Precautions Requirements for inspection: 1 The sniper strength should be appropriate during the percussion, and should not be too light or too heavy; 2 When the right middle line and the right shoulder line are diagnosed, the left side of the subject can be taken; 3 Because the lower hepatic border overlaps with the organs such as the stomach and colon, it is difficult to accurately locate the percussion, so palpation or hearing can be used. Inspection process The examinee took the supine position and the legs flexed. The examiner stands on the right side of the examinee and uses an indirect percussion method along the right midclavicular midline, right iliac midline and right scapula line, from the lung area down to the abdomen. When it is changed from unvoiced to voiced, it is the upper boundary of the liver, which is called the relative dullness of the liver. Then squat down 1 to 2 intercostal, from voiced to real, called the absolute voice of the liver (also the lower lung). Determine the lower hepatic margin, which can be seen from the abdominal drum sound zone along the right clavicle midline or the anterior midline. When the drum sound is changed to voiced sound, it is the lower hepatic boundary. Spleen percussion method: The determination of the spleen voiced area should be based on the sputum method. The patient is lying supine or in the right lateral position. The examiner uses the finger-pointing method to follow the left-middle midline and then pats the posterior and posterior. When the voice is changed from unvoiced to voiced, it is the edge of the spleen. Then continue to see the patient and become a drum. When the sound (stomach bubble drum area), it is the spleen front. Not suitable for the crowd Inappropriate people: Basically no suitable for the crowd, but people with mental disorders should pay attention. Adverse reactions and risks Nothing.

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