Ascites physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Physical examination of patients with ascites is usually remarkable for flank dullness, shifting dullnes, and fluid wave. The presence of decreased breath sounds or dull percussion in lower chest on physical examination is diagnostic of pleural effusion beside ascites.
Physical Examination
- Physical examination of patients with ascites is usually remarkable for flank dullness, shifting dullnes, and fluid wave.
- The presence of decreased breath sounds or dull percussion in lower chest on physical examination is diagnostic of pleural effusion beside ascites.[1]
- Physical exam findings in patients with ascites are as followings:[2]
Appearance of the Patient
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- Patients with ascites usually appear ill.
Vital Signs
- Low-grade fever
- Hypothermia may be present
- Tachypnea
- Kussmaul respirations may be present in advanced disease state
Skin
HEENT
Neck
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Lungs
- Decreased breath sounds
- Dull percussion in lower chest
Heart
Abdomen
- Abdominal distention
- Abdominal tenderness in the right upper abdominal quadrant
- Splenomegaly
- Caput medusa
- Gynecomastia
Back
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- Back examination of patients with ascites is usually normal.
Genitourinary
Neuromuscular
- Patient may be not oriented to persons, place, and time
- Altered mental status
- Asterixis (flapping tremor)
- Clonus may be present
Extremities
References
- ↑ Cattau EL, Benjamin SB, Knuff TE, Castell DO (1982). "The accuracy of the physical examination in the diagnosis of suspected ascites". JAMA. 247 (8): 1164–6. PMID 7057606.
- ↑ Walker, H (1990). Clinical methods : the history, physical, and laboratory examinations. Boston: Butterworths. ISBN 0-409-90077-X.