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In gastroenterology, the puddle sign is a physical examination maneuver that can be used to detect the presence of ascites.

It is useful for detecting small amounts of ascites -- as small as 120 mL; shifting dullness and bulging flanks typically require 500 mL.[1]

In relation to auscultatory percussion, the puddle sign is more specific, but less sensitive.[2]


  1. Shah R. Ascites. eMedicine.com. URL: http://www.emedicine.com/med/topic173.htm. Accessed on: September 17, 2007.
  2. Chongtham DS, Singh MM, Kalantri SP, Pathak S (1997). "A simple bedside manoeuvre to detect ascites". The National medical journal of India. 10 (1): 13–4. PMID 9069699.

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