Ascites Examination

ASCITES EXAMINATION 

 

1. Puddle sign :

·         Patient lays down in prone position with raised elbow and knee for 5 minutes

·         The diaphragm part of stethoscope is located on the medial of lower abdomen

·         The physician (examiner) listening to sound which is appear when fingers percuss the lateral abdomen

·         Keep conducting finger percussion while stethoscope is being moved away from the physician

·         If the edge of fluid gather is being reached, sound intensity will be louder

2. Shifting dullness

·         Percuss abdomen from the medial side to the lateral side, determine the edge of thympanic and dullness sound

·         Ask the patient to lay down in lateral position

·         Ascites sign will be positive if thympanic sound is changed to dullness in the same location in the abdomen.

3.Fluid Wave (undulation test) :

·         Put the examiner ‘s hand or patient ‘s hand on the middle of abdomen vertically

·         Compress the hand on the abdomen partitian

·         Percuss one side in the waist while the other hand palpates the waist in the opposite area.

·        Feel the fluid wave in the abdomen