The physical examination can help make a diagnosis of cirrhosis. The obvious findings like ascites, asterixis and palmar erythema are not always present, so the astute clinician must also be on the lookout for more subtle findings.
A cirrhotic liver can be either shrunken or enlarged, so the rostral-caudal span is not that helpful. However! Cirrhotic livers frequently have left lobe hypertrophy. This is detected below the xyphoid process/costal margin (midline of the abdomen). So, a palpable liver edge there…combined with a high pretest probability of cirrhosis, can be very helpful.
In the above image, note the extensive right-to-left span of the left lobe. A liver this large should be palpable by physical exam. Happy hunting.