Liver

POCUS of the liver can be helpful in the patient with acute RUQ pain/ deranged LFTs/ clinically enlarged liver.

Examine the liver with US for:

1. enlargement

2. echogenicity

3. dilated intrahepatic ducts

4. intraheptic lesions eg malignancy/ abscess

5. vascular abnormality eg portal vein thrombosis

LIVER SIZE

An enlarged liver is easy to palpate clinically. But if you really want an US measurement, the easiest way to do this is to image the liver as you would for the EFAST RUQ view: ie probe marker to the head, longitudinal probe position at the R lateral intercostal space.

Translate the probe cranially to visualise the diaphragm above the liver. Measure from the diaphragm to the caudal tip of the liver in a straight line. An enlarged liver will be >16cm (1).