The Importance of a Coexistent Hepatic Rub and Bruit

Authors:
  • HSHoward I. Sherman
    Howard I. Sherman
  • JHJoseph E. Hardison
    Joseph E. Hardison
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Abstract
FRICTION rubs heard over the liver result from inflammation or necrosis.1,2Hepatic rubs may occur in metastatic cancer,3gonococcal perihepatitis,4alcoholic cirrhosis,1pyogenic abscess,1,5bile duct carcinoma, viral hepatitis, perihepatitis secondary to systemic lupus erythematosus, cholecystitis, and tuberculous peritonitis.1 Hepatic arterial bruits have been reported to occur in malignant hepatoma, metastatic cancer of the liver, and alcoholic hepatitis.6 We postulated the presence of a hepatic rub and bruit in the same patient would be indicative of a malignant neoplasm in the liver. Patients and Methods Approximately 1,000 patients were examined the morning after their admission to general medical wards at the Veterans Administration Hospital and Grady Memorial Hospital during a two-month period. Auscultation was carried out in four quadrants of the abdomen to detect rubs and bruits. Organomegaly was determined by palpation. Results Bruits From Large Vessels.— Four patients without hepatomegaly had systolic

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