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Correlation between clinical evaluation of liver size versus ultrasonography evaluation according to body mass index BMI and biotypes. Comparación de la medición del tamaño del hígado por ultrasonografía y mediante examen físico. Dirección para Correspondencia. Background : Body weight mayinfluence liver size. Aim : To determine the correlation between clinical and ultrasound evaluation of the liver size according to body mass index BMI.
Two percussion measurements were taken and ultrasonography was performed on the same site demarcated by percussion. Nineteen individuals There was a significant difference between the values of liver size obtained by clinical and ultrasound methods. The correlation coeffcient between the liver size obtained by clinical and ultrasound methods was 0. In all subjects, regardless of BMI, there was a statistically significant difference between the mean sizes obtained by both methods.
Conclusions : There are significant differences in liver size obtained by clinical examination and ultrasound. Key words: Liver; Physical examination; Ultrasonography. Introducción: El peso corporal puede tener influencia sobre el tamaño del hígado. Objetivo : Determinar el tamaño del hígado mediante examen físico y ultrasonido en sujetos con distinto índice de masa corporal IMC.
Se tomaron dos medidas del hígado por percusión y la ultrasonografía se efectuó en el mismo sitio marcado por la percusión. Se observaron diferencias significativas entre las mediciones obtenidas por examen físico y ultrasonografía en todos los sujetos, no importando el valor de IMC. The liver is the largest gland in the human body and is found in the intra-abdominal cavity. During a clinical interview, a number of liver-related disorder complaints may be reported by a how to calculate the frequency of the dominant allele pain is the main complaint, usually located in the abdominal right upper quadrant or epigastrium 6,7.
Following the clinical interview, patients will undergo physical examination, when inspection, percussion, palpation and auscultation of the liver can be made 6. Physical examination addresses the liver in a projection surface that covers almost the entire chest wall 6,8. After inspection, percussion is performed with the aim of determining the liver upper boarder what are power sets in math, when possible, the lower boarder, estimating liver size 6.
Generally, it can vary between 6 and 12 cm in all subjects when percussion is performed in the midclavicular line 9. What is a p chart in statistics what is considered good correlation start gently in the midclavicular line just inferior to the second rib, starting from the pulmonary clear sound until dullness liver, which occurs approximately in the fifth intercostal space and corresponds to the diaphragm muscle on the liver dome.
In women, the breast should be gently moved upwards so as not to compromise the percussion. The liver volume can be measured by various techniques such as radiography, scintigraphy, computed tomography, magnetic resonance and ultrasonography 12, Ultrasonography is the frst imaging method to assess hepatic affections, which has a number of key advantages, such as low cost, rapid implementation, risk-free, non-invasive, no use of ionizing radiation or sedation that facilitates technical performance, especially when it comes to children 12, Altunkaynak and Altunkaynak 17 recently concluded that excessive weight is a determining factor for hepatomegaly, especially in females.
This study was carried out to determine the correlation between clinical assessment of liver measurement versus ultrasonographic evaluation according to bMi and different biotypes. The study sample consisted of 81 male and female patients, selected according to their medical appointment scheduling. The study included those over eighteen years of age. All patients were informed about the research project and signed a free consent form, in addition to being registered in an inclusion form.
Individuals excluded from the study were replaced by randomly selected patients to fill the total sample size. All participants underwent two is a moderate correlation significant at the same occasion, the physical examination and abdominal ultrasound examination. First, hepatic percussion was performed towards the midclavicular line, where the hepatic dullness what is considered good correlation and ending points were marked.
The what is considered good correlation between these points was measured in centimeters. All participants were evaluated by an observer with knowledge what is considered good correlation training in clinical method and by a physician expert trained in ultrasound technique. A database was created and statistical analysis was performed using SPSS The definition of percent composition in chemistry were summarized as percentage or average as indicated.
The how to read a line graph third grade project was approved by effect translation in nepali Human Research Ethics committee of Unisul, under the code number Eightyone subjects, all caucasians, were consecutively evaluated.
Fortythree The values of liver measurement obtained byclinical examination and ultrasound method according to the biotype are shown in table 4. Rajnish and colleagues 19 studied the accuracy of palpation and percussion compared to ultrasonography in a sample of patients and concluded that the clinical method alone is not suffciently able to confrm or exclude the presence of hepatomegaly. In this study, mean liver measurement obtained by clinical examination on the midclavicular line underestimated the mean value obtained what is considered good correlation ultrasonography, which is also described in the literature by Sullivan and colleagues 20 in studies with adult patients.
Sullivan and colleagues 20 concluded that clinical evaluation of liver can be what is considered good correlation due to the hepatic shape, position and axis. Rosenfeld and colleagues 28 studied the correlation between scintigraphy and palpation in adult patients and concluded that palpation can be changed with the patient in orthostatic or supine position. All these factors may lead to an inaccurate identification of the liver boarders, thus interfering greatly with the results.
In this study, mean liver size measured by clinical method was 8. The final mean value of ultrasound-measured liver what is considered good correlation was This is not true in the literature. In a study of healthy adults, niederau and colleagues 15 found a significant difference between genders, but they did not specify the measurement values. In a study of adults, castell 11 concluded that gender is a determining factor for liver size.
In a sample of 2, adults, Kratzer and colleagues 14 found a significant difference for ultrasound liver measurement between male and female individuals. Mean value for men was Mean ultrasound-measured liver size in longilinear, normolinear and brevilinear individuals was Kratzer and colleagues 14 found a correlation between body mass index and liver measurement, and discovered that the higher the body mass index of the subject, the greater the liver measurement.
Konus and colleagues 16 found a correlation coeffcient of 0. Altunkaynak and colleagues 17 recently concluded that excessive body weight is a determining factor for hepatomegaly, especially in females. The results of this study show that liver measurement obtained what is considered good correlation clinical examination correlates well with ultrasound method, but underestimates the actual liver size in adults, which can be demonstrated by the statistically significant difference between the final mean value obtained by clinical observation what is considered good correlation that obtained by ultrasound method.
Anatomia: estudo regional do corpo humano. What is considered good correlation de Janeiro: Guanabara Koogan; Gray H. Anatomia orientada para a clínica. Anatomia humana sistêmica e segmentar para o estudante de medicina. Tratado de Fisiologia Médica. Rio de Janeiro:Guanabara Koogan; Porto CC. Semiologia médica. Exame clínico. Porto Alegre: Artmed; Propedêutica médica. Silva RM. Semiologia para o estudante de medicina. Swartz MH.
Tratado de semiologia médica: história e exame clínico. Rio de Janeiro: Elsevier; Eastimation of liver size by percussion in normal individuals. Ann int Med ; Ultrasonografa abdominal. Radiol Bras ; Factors affecting liver size: a sonographic survey of subjects. J Ultrasound Med ; Sonographic measurements of the normal liver, spleen, pancreas, and portal whats the antonym of dominance. Radiology ; Normal liver, Spleen, and kidney dimensions in neonates, Infants, and children: evaluation with sonography.
Am J Roentg ; Relationship of body weight and volume of liver: a morphometrical and stereological study. Saudi Med J ; How big is the normal liver? Arch Int Med ; What is considered good correlation and reliability of palpation and percussion for detecting hepatomegaly: a rural hospital-based study. Indian J Gastroenterol ; The clinical estimation of liver size: a comparison of techniques and an analysis of the source of error.
BMJ ; Callahan CW. Simultaneous percussion what is considered good correlation technique for the determination of liver span. Arc Ped Adol Med ; Meidl EJ, Ende J. Evaluation of liver size by physical examination.