Percussion of Spleen

Traube’s semilunar space


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


  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)


  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

One Viewpoint 💬 on “Percussion of Spleen”

  1. As for Nixon’s method- if dullness is beyond 8cms on a perpendicular line from middle of left costal margin,it means spleen is enlarged upto costal margin.This can be easily picked up by hooking method or Medleton’s manuare.Nixon’s method becomes superfluous.
    Well ,dullness lower anterior chestwall may indicate pleural effusion or pleural thickening or even a fundal growth in the stomach .We need to ponderon that.

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