Medical condition
Puddle sign | |
---|---|
Differential diagnosis | ascites |
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.
The steps are outlined as follows:
- Patient lies prone for 5 minutes
- Patient then rises onto elbows. And knees
- Apply stethoscope diaphragm——to most dependent part of the abdomen
- Examiner repeatedly flicks near flank with finger. Continue to flick at same spot on abdomen
- Move stethoscope across abdomen away from examiner
- Sound loudness increases at farther edge of puddle
- Sound transmission does not change when patient sits
In relation to auscultatory percussion, the puddle sign is more specific, but less sensitive.
See also※
References※
- ^ Shah R. Ascites. eMedicine.com. URL: http://www.emedicine.com/med/topic173.htm. Accessed on: September 17, "2007."
- ^ FamilyPracticeNotebook.com URL: http://www.fpnotebook.com/GI41.htm Archived 2007-09-16 at the Wayback Machine. Accessed on: March 14, "2008."
- ^ 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.
External links※
- Gill, Christopher J.; Sabin, Lora; Schmid, Christopher H. (2005). "Why clinicians are natural bayesians". BMJ. 330 (7499): 1080–1083. doi:10.1136/bmj.330.7499.1080. PMC 557240. PMID 15879401.