Ariel I M, Briceno M
Med Pediatr Oncol. 1976;2(1):69-73. doi: 10.1002/mpo.2950020108.
The liver extended a minimum of 5 cm inferior to the right costal margin in 51% of the 504 patients studied. In 53% of these patients, experienced, mature physicians declared that the liver was not palpable on physical examination. In 3% of the cases, a mass was palpated which was believed to be liver by the examining physician but was found to be extrahepatic upon scanning and laparotomy. The unreliability of physical examination in determining whether or not the liver extends inferior to the costal margin in many instances is demonstrated.