Examination of abdomen is done to figure out which area of patient is affected and to approach the cause of symptoms. It involves Inspection, Palpation, Percussion and Auscultation. Let’s have a look in short on format of Examination of abdomen:
Inspection- Patient should lie flat on his back with legs extended.
- First inspect all hernia orifices
- Contour of abdomen
- Respiratory movements
- Peristaltic movements
- Look for pulsating swellings
Palpation- Volar surface of fingers is employed to palpate.
- Hyperesthesia- Look for hypersensitivity.
- Tenderness- Do not ask the patient if he’s having pain on touching, instead palpate and observe the patients face for pain reaction.
- Muscular rigidity- It is involuntary in parietal peritonitis and voluntary due to fear of patient and not due to parietal peritonitis.
Percussion- Tap the fingers to observe dullness or hyper-resonance.
- Shifting dullness
- Obliteration of liver dullness- if resonance replaces dullness, it is due to free gas presence.
Hear peristaltic sounds- if they are silent, then it could be diffuse peritonitis. If they are noisy, it could be active intestine obstruction.
Apart from these, perform rectal examination and vaginal examination after taking consent of patient.