The Importance of a Coexistent Hepatic Rub and Bruit

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. <h3>Patients and Methods</h3> 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. <h3>Results</h3><h3>Bruits From Large Vessels.—</h3> Four patients without hepatomegaly had systolic