Clinical Examination of the Abdomen

Percussion of the Abdomen: Identification of Tympany, Dullness, and Assessment of Ascites

Percussion is a crucial aspect of the clinical examination of the abdomen, enabling physicians to evaluate underlying structures by assessing sound variations. This technique aids in detecting abnormalities such as ascites.

Understanding Percussion Sounds

Different percussion sounds provide valuable diagnostic clues:

• Tympany: A drum-like sound produced when percussing over air-filled structures, most commonly the intestines.
• Dullness: A thud-like sound indicating solid organ presence, such as the liver or an enlarged spleen.

Techniques for Abdominal Percussion

1. Position the patient supine in a relaxed state.
2. Systematically percuss all quadrants, noting any changes in sound.
3. Compare symmetrical areas to detect inconsistencies.

Assessment of Ascites

Ascites, the accumulation of fluid in the peritoneal cavity, alters percussion findings.

• Shifting Dullness: Dullness shifts when the patient changes position, suggesting free fluid.
• Fluid Wave Test: Placing one hand on the flank and tapping the other side can produce a fluid wave.

Conclusion

Percussion serves as an invaluable tool in abdominal examination, aiding in differential diagnoses and guiding further investigative methods.