Method Of Exam

Author: A. Chandrasekhar, MD Consultant: J. Pickleman, MD and M. Klamat, MD

Bimanual palpation

Stand on the patient's right side and with your left hand, pull the patient's rib cage anteriorly and palpate for the tip of the spleen (if enlarged) with your right hand as the patient takes a deep breath.

Alternate method of exam: An alternate method can be utilized if the spleen tip was not palpable by the other methods. Position the patient in the right lateral decubitus position (legs somewhat flexed at the hips and knees). In this position gravity may bring the spleen downward.



You should try to palpate spleen by superficial palpation and not deep palpation. Splenic tip is just hugging anterior abdominal wall. With superficial palpation, let the splenic tip come and touch your fingers with deep breathing rather than you going after spleen.