- Puddle sign
In
gastroenterology , the puddle sign is aphysical examination maneuver that can be used to detect the presence ofascites .It is useful for detecting small amounts of ascites -- as small as 120 mL;
shifting dullness andbulging flanks typically require 500 mL. [Shah R. Ascites. eMedicine.com. URL: [http://www.emedicine.com/med/topic173.htm http://www.emedicine.com/med/topic173.htm] . Accessed on: September 17, 2007.]The steps are outlined as follows:
1. Patient lies prone for 5 minutes 2. Patient then rises onto elbows and knees 3. Apply stethoscope diaphragm to most dependent abdomen 4. Examiner repeatedly flicks near flank with finger. Continue to flick at same spot on abdomen 5. Move stethoscope across abdomen away from examiner 6. Sound loudness increases at farther edge of puddle 7. Sound transmission does not change when patient sits [FamilyPracticeNotebook.com URL: [http://www.fpnotebook.com/GI41.htm http://www.fpnotebook.com/GI41.htm] . Accessed on: March 14, 2008.]
In relation to auscultatory percussion, the puddle sign is more
specific , but less sensitive. [cite journal |author=Chongtham DS, Singh MM, Kalantri SP, Pathak S |title=A simple bedside manoeuvre to detect ascites |journal=The National medical journal of India |volume=10 |issue=1 |pages=13–4 |year=1997 |pmid=9069699 |doi=]References
ee also
*
Abdominal examination
*Fluid wave test
*Bulging flanks External links
* [http://www.fpnotebook.com/GI41.htm Puddle sign] - fpnotebook.com.
* [http://www.bmj.com/cgi/eletters/330/7499/1080 Puddle test (discussion in relation to EBM)] - bmj.com
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