Percussion of Spleen

Traube’s semilunar space

Borders:

  1. Superiorly: Left 6th rib superiorly
  2. Laterally: Left midaxillary line or Left anterior axillary line
  3. Inferiorly: Left costal margin

Method:

  1. Patient’s position: supine with left arm slightly abducted.
  2. Percuss: from medial to lateral

Interpretation: Resonance (Normal) and Dullness (Splenomegaly)

  • Also: Pleural effusion or mass in stomach may cause dullness in Traube’s space.

Castell’s method

Patient’s position: Supine

Percuss: In the lowest intercostal space in the anterior axillary line (8th or 9th)

Interpretation:

  1. Resonant percussion note on expiration or full inspiration: normal
  2. Dull percussion note on full inspiration: splenomegaly
spleen percussion
Top-left: Nixon’s method; Top-right: Traube’s space and Castell’s method; Bottom: Line of splenic enlargement

Nixon’s method

Patient’s position: Right lateral decubitus (rationale: spleen comes to lie above colon and stomach).

Percuss: start percussing midway along the left costal margin and proceed in a line perpendicular to left constal margin

Interpretation: Upper limit of dullness >8 cm above costal margin: Splenic enlargement

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