Other Known Aliases – none
Definition – percussion point on the lowest intercostal space (usually 8th or 9th) in the left anterior axillary line
Clinical Significance – This point is an alternative maneuver to clinically determine if a patient has splenomegaly. With the patient in the supine position, have the patient fully expire and begin percussing in this point while the patient fully inspires. At full expiration, resonance should be appreciated from either the splenic flexure of the colon or gas in the stomach. During inspiration, the spleen moves inferiorly and, if enlarged, will enter this point. This will change the percussion from resonance to dullness.
History – Named after Donald Castell (1935-2021), an American gastroenterologist who received his medical doctorate from George Washington University in 1960. He would spend the majority of his career in the Navy culminating in chair of the Department of Medicine at the National Naval Medical Center in Bethesda, MD. He also held numerous leadership positions national in the American Gastroenterology Association and had a prolific career in scholarship and research. It was through this passion for research that he published his eponymous finding in 1967 while stationed in the Great Lakes naval base in Illinois.
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- Castell DO. The spleen percussion sign. A useful diagnostic technique. Ann Intern Med. 1967; 67(6):1265-7. [pubmed]