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Fluid Wave Test
In medicine, the fluid wave test or fluid thrill test is a test for ascites (free fluid in the peritoneal cavity). It is performed by having the patient (or a colleague) push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap. The pressure on the midline prevents vibrations through the abdominal wall while the fluid allows the tap to be felt on the other side. The result is considered positive if tap can be felt on the other side. However, even with the midline pressure, transmission through the skin must be excluded. A positive fluid wave test indicates that there is a free fluid (ascites) in the abdomen. When one side of the abdomen is pressed, the other side may also be painful due to the transfer of the fluid in it. See also * Abdominal examination * Bulging flanks * Puddle sign * Shifting dullness In medicine, shifting dullness refers to a sign elicited on physical examination for ascites (fluid in th ...
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Medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others. Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of skill and knowledge), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, o ...
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Ascites
Ascites is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Complications can include spontaneous bacterial peritonitis. In the developed world, the most common cause is liver cirrhosis. Other causes include cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein. In cirrhosis, the underlying mechanism involves high blood pressure in the portal system and dysfunction of blood vessels. Diagnosis is typically based on an examination together with ultrasound or a CT scan. Testing the fluid can help in determining the underlying cause. Treatment often involves a low-salt diet, medication such as diuretics, and draining the fluid. A transjugular intrahepatic portosystemic shunt (TIPS) may be placed but is associated with co ...
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Abdominal Examination
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The physical examination typically occurs after a thorough medical history is taken, that is, after the physician asks the patient the course of their symptoms. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen. Auscultation (listening) of the abdomen with a stethoscope. Palpation of the patient's abdomen. Finally, percussion (tapping) of the patient's abdomen and abdominal organs. Depending on the need to test for specific diseases such as ascites, special tests may be performed as a part of the physical examination. An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity (including the liver, spleen, large or small intestines), or simpl ...
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Bulging Flanks
Ascites is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Complications can include spontaneous bacterial peritonitis. In the developed world, the most common cause is liver cirrhosis. Other causes include cancer, heart failure, tuberculosis, pancreatitis, and blockage of the hepatic vein. In cirrhosis, the underlying mechanism involves high blood pressure in the portal system and dysfunction of blood vessels. Diagnosis is typically based on an examination together with ultrasound or a CT scan. Testing the fluid can help in determining the underlying cause. Treatment often involves a low-salt diet, medication such as diuretics, and draining the fluid. A transjugular intrahepatic portosystemic shunt (TIPS) may be placed but is associated with co ...
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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. 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 *Abdominal examination An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of di ...
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Shifting Dullness
In medicine, shifting dullness refers to a sign elicited on physical examination for ascites (fluid in the peritoneal cavity).Murray Longmore, Ian B. Wilinson, Edward H. Dawvidson, Alexander Foulkes and Ahmad R. Mafi ''Oxford Handbook of Clinical Medicine'' 8thEdition Oxford University Press 2010 The test is performed by first percussing the midline of the abdomen to elicit a resonant note due to gas in the abdomen. If there is no area of resonance, then the test cannot be performed. Percussion is then moved progressively more laterally (away from the examiner) – this is depicted as the red section in the diagram on the right – until the note becomes dull, as depicted by the green section. The examiner's index finger remains on the resonant side, and the middle finger remains on the dull side, straddling the fluid-air level. The patient is then asked to lean on their right lateral side (assuming the examiner used the traditional right-sided approach). This stabilises the pati ...
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Diagnostic Gastroenterology
Gastroenterology (from the Greek gastḗr- “belly”, -énteron “intestine”, and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, sometimes referred to as the ''GI tract,'' which includes the esophagus, stomach, small intestine and large intestine as well as the accessory organs of digestion which includes the pancreas, gallbladder, and liver. The digestive system functions to move material through the GI tract via peristalsis, break down that material via digestion, absorb nutrients for use throughout the body, and remove waste from the body via defecation. Physicians who specialize in the medical specialty of gastroenterology are called gastroenterologists or sometimes ''GI doctors''. Some of the most common conditions managed by gastroenterologists include gastroesophageal reflux disease, gastrointestinal bleeding, irritable bowel syndrome, irritable bowel disease ...
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