Splenic enlargement and Traube's space: how useful is percussion?
OBJECTIVE
The utility of Traube's space percussion in the bedside assessment of splenic enlargement was evaluated. The influence of meals and obesity on this sign were also assessed, because both are believed to interfere with the results of abdominal percussion.


METHODS
The inpatient population of a tertiary care hospital was studied where cases and controls were selected according to the results of abdominal ultrasonographic examinations.


RESULTS
Traube's space percussion exhibited a sensitivity of 0.62 (95% confidence interval [CI], 0.51 to 0.71) and a specificity of 0.72 (95% CI, 0.65 to 0.80) when classifying tympanitic examinations as negative. False-positive examinations were reduced by assessing patients more than two hours after mealtime. Obese patients were a source of false-negative examinations.


CONCLUSIONS
Traube's space percussion compares favorably with other commonly used clinical maneuvers and diagnostic tests. When performed alone in a selected patient population, it adds useful clinical information but is not sufficiently sensitive or specific to obviate the need for further diagnostic testing.
Barkun
A N
AN
Division of General Internal Medicine, Montreal General Hospital, Quebec, Canada.
Camus
M
M
Meagher
T
T
Green
L
L
Coupal
L
L
De Stempel
J
J
Grover
S A
SA
D000328:Adult; D000368:Aged; D004435:Eating; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010474:Percussion / Q000379:methods*; D011237:Predictive Value of Tests; D013163:Splenomegaly / Q000150:complications / Q000175:diagnosis*; D014463:Ultrasonography