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J Korean Radiol Soc. 1980 Jun;16(1):287-294. Korean. Original Article. https://doi.org/10.3348/jkrs.1980.16.1.287
Kim BS .
Abstract

The author studied, with emphasis on the various radiographic projections, the 99 cases of liver enlargement,which underwent the barium meal upper gastrontestinal exminations for the purpose of pursuit of significance ofliver enlargement and, at the same time, were confirmed by other clinical and pathological methods at BusanNational Uniersity Hospital for about 2 years from Nov. 1977 to Sep. 1979. The following results were obtained; 1.The incidence of liver enlargement was 63.3%(63 cases ) in the 5th decade, which was most prevalent, 18.2%(18cases) in the 3rd decade, 15.2%(15 cases) in the age group over 60, and 3.0%(3 cases) in the age group below 20.Male to female sex ratio was 2:1. 2. The causes of the liver enlargement confirmed by the final diagnosis are asfollows; Primary hepatic cancer 39 cases (39.3%), liver cirrhosis 30 cases(30.3%), chronic active hepatitis 12cases(12.1%), cancer of the biliary tract 6 cases (6.1%), hepatic fluke 6 cases(6.1%), metastatic tumor 3 case(3.0%), and hepatic congestion 3 cases (3.0%). 3. In the prone view, the displacement of the duodenal bulbappeared in 18 cases (18.2%). 4. In the routine radiographs, the displacement of the stomach to the left and thepressure indentation of the lesser curvature were noted in 69 cases(69.7%) out of the 99 cases. 5. In the leftlateral recumbent view, the pressure indentation of the anterior border of the gastric body was seen in 96 case(97.0%) among the 99 cases, the straightening in 30 cases (27.3%), the marked depression in 30 cases (30.3%), themoderate in 27 cases (27.3%), the minimal in 9 cases (9.1%). 6. Comparing the incidences of the roentgen findingsof the liver enlargement in the various projections respectievly, the displacement of the duodenal bulb was notedin 18 cases (18.3%) in the prone position. The erect position revealed the displacement of the stomach to the leftand the pressure indentation in 57 cases (57.6%), the prone position in 51 cases (51.5%), and the supine view in36 cases (36.4%). The left lateral recumbent view, however, demonstrated the good result of 96 cases (97.0%). 7.The cases of the liver enlargement unable to be detected by physical examination could be found in 39 cases(39.4%)in the left lateral recumbent projections. 8. Even in some cases of hepatic cancer invading the right lobe of theliver and those showing no significant findings in the routine views, the left lateral recumbent view demonstratedthe pressure indentation. 9. The left lateral recumbent view showed the more prominent pressure indentation thanthe left lateral erect projection. 10. Consequently, the author concluded that the left lateral recumbent was thebest position to reveal the liver enlargement and had the high accuracy.

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