Puddle sign
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]
The steps are outlined as follows:[2]
- 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.[3]
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. 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
- Puddle sign - fpnotebook.com.
- Puddle test (discussion in relation to EBM) - bmj.com
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