Adam III: Third Time Lucky?

Blood & Lymphoreticular System


{"ops":[{"insert":"Splenomegaly: the Castell sign"},{"insert":"\n","attributes":{"header":1}},{"insert":"In patients with suspected or expected splenomegaly, palpation of the spleen is not always the best technique for detection. In certain cases, palpation may even be risky, e.g., in infectious mononucleosis where vigorous palpation may result in splenic rupture.\n\nPercussion is a better technique for assessing splenic size. Eliciting the Castell sign is one such method; this involves percussion of the lowest intercostal space, along the left anterior axillary line. In patients with a non-enlarged spleen, this elicits a resonant sound.\n\nA positive Castell sign (indicating splenomegaly) occurs when percussion of this space elicits dullness, especially on full inspiration. This may change to a resonant note on full expiration.\n"}]}

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