Abdominal examination

The abdominal exam, in medicine, is performed as part of a physical examination, or when a patient presents with abdominal pain or a history that suggests an abdominal pathology.

The abdominal exam has conventionally been split into different stages:

According to Mosby's, "The abdominal exam is performed as part of the comprehensive physical examination or when a patient presents with signs of symptoms of an abdominal disease process." In other words, your doctor will often perform an abdominal exam as part of a routine examination. However, your doctor might perform additional tests if your doctor feels that you might have an abdominal disease.

A suggested position is for the patient to be supine (on their back), with their arms to their sides. The patient should be placed in an environment with good lighting, and should be draped with towels or sheets to preserve privacy and warmth

Although physicians have had concern that giving patients pain medications during acute abdominal pain may hinder diagnosis and treatment, separate systematic reviews by the Cochrane Collaboration and the Rational Clinical Examination refute this.

The abdominal exam typically begins a visual examination of the abdomen. Some common things an examiner might look for are:

In addition, a doctor might look/check for specific signs of disease, such as:

Auscultation refers to the use of a stethoscope by the examiner to listen to sounds from the abdomen. This is a very subjective procedure.

Unlike other physical exams, auscultation is performed prior to percussion or palpation, because both might alter abdominal sounds.

Some controversy exists as to the length of time required to confirm or exclude bowel sounds, with suggested durations up to seven minutes. Bowel obstruction may present with grumbling bowel sounds or high-pitched noises. Healthy persons can have no bowel sounds for several minutes and intestinal contractions can be silent. Absence of sounds may be caused by peritonitis, paralytic ileus, bowel obstruction, intestinal ischemia or other causes. Some authors suggest that listening at a single location is enough as sounds can be transmitted througout the abdomen.

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