Abdominal examination revealed the liver to be 2cm below right costal margins
and the spleen was 4cm below left costal margin
, while lymphadenopathy was not present.
It was about 1.5 mm linear tear, which was sutured laparoscopically with 3-0 polyglactin 910 with the help of two 5 mm ports inserted below right and left costal margins
without any postoperative sequelae.
Holmes in 1943 proposed that pain in slipping rib syndrome is caused by recurrent subluxation of the costal margins
of the 8th, 9th and 10th ribs making these ribs in close contact and cause irritation of the intercostal nerves.
At admission, she presented with hypoesthesia of superficial sensibility from bilateral costal margins
to knees, positive bilateral Hoffman sign, and Babinski sign.
The abdomen was not distended, the palpation revealed no tenderness, the liver and spleen edges were parallel to costal margins
. The frequency and consistency of the stools were normal.
No exanthema was noted, the liver was palpable 1 cm under the costal margins
, and the spleen was not enlarged.
DIAGNOSIS: Pinophylus is distinguished from other conifer inhabiting genera of Phylini by the distinctive sexual dimorphism, with the costal margins
of the hemelytra elongate and parallel-sided in the male and shorter and subovoid in the female; the brownish black dorsum with inconspicuous dark simple setae; the pretarsus with the base of the claw expanded and the pulvillus small; and the endosoma composed of two straps with a subapical secondary gonopore.
DE refers to thinning of all or part of the hemidiaphragm while maintaining continuity with the costal margins
, resulting in elevation and cranial displacement of intra-abdominal viscera on the affected side.
The liver and spleen were palpable 10 cm and 11 cm below the costal margins
The entire physical examination of this active thriving infant is normal, except that he has a prominent liver and spleen by palpation, each approximately 6-7 cm below the costal margins
. How would you proceed?
Physical examination revealed a firm mass about 2 cm below the costal margins
about 5 x 3 cm, globular and moving with respiration.
Distinguished from Schuhistes leckkersingia by the presence of a golden partial to complete fascia on the anterior half of the hemelytra, the straighter costal margins
of the hemelytra in the males, the smaller size and C-shape of the vesica, and the narrow more-or-less parallel-sided apex of the phallotheca.