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KMID : 0378019820250050045
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New Medical Journal
1982 Volume.25 No. 5 p.45 ~ p.51
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The diagnostic significance of hepatic area tenderness caused by punching in cases of liver disease
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Abstract
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The authors found a pain caused in the deep part of hepatic area by punching the right lower rib cage of liver disease patients.
For evaluation of its diagnostic significance as a screening test of suspected liver disease patients, the authors studied 56 patients who felt hepatic area tenderness when punched, in spite of normal findings in biochemical liver function test by SMA-12.
The authors checked, for confirmation of the liver disease of each patient, viral markers such as HBs Ag and Anti-HBc by the radioimmunoassay method, the ultrasonography of the hepatobiliary system, the liver scan by198Au colloid, the liver needle biopsy by Vim Silverman needle.
The results were as follows:
1) The number of patients who seemed to be or to have been exposed to hepatitis B virus was 51 (91%), the percentage of which is much higher than the positive rate (56.8^-78%) in the population of Seoul area.
2) The patients who revealed abnormal findings on liver scan were 52 (93%). The reliability of the punch method was 90% or higher even if one considered the generally accepted false positive rate (2.5%) in the reading of the liver scan.
3) On liver needle biopsy, the number of patients who showed abnormal pathologic findings. was 44 (79%). So the reliability of the punch method was 79-945o/ even if regarding the false negative rate (19,30%) of the liver needle biopsy.
In view of the above results, the punch method is very significant and useful in the first step of screening when liver disease is suspected, easy to practice, and a non invasive technique, and costs nothing at all.
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