Puddle sign
Encyclopedia
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:
In relation to auscultatory
percussion
, the puddle sign is more specific
, but less sensitive
.
Gastroenterology
Gastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words gaster , enteron , and logos...
, the puddle sign is a physical examination
Physical examination
Physical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient...
maneuver that can be used to detect the presence of ascites
Ascites
Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity.The medical condition is also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy. Although most commonly due to cirrhosis and severe liver...
. It is useful for detecting small amounts of ascites -- as small as 120 mL; shifting dullness
Shifting dullness
In medicine, shifting dullness refers to a sign, elicited on physical examination, for ascites.To perform the test, first the midline is percussed eliciting a resonant note due to gas in the bowel. If there is no area of resonance then the test cannot be performed...
and bulging flanks
Bulging flanks
In medicine, bulging flanks refers to a sign for ascites. If, on inspection , the sides of the abdomen bulge outward in an unusual fashion on a patient, they likely have fluid in the abdomen...
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
Auscultation
Auscultation is the term for listening to the internal sounds of the body, usually using a stethoscope...
percussion
Percussion (medicine)
Percussion is a method of tapping on a surface to determine the underlying structure, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the four methods of clinical examination, together with inspection, palpation and auscultation...
, the puddle sign is more specific
Sensitivity and specificity
Sensitivity and specificity are statistical measures of the performance of a binary classification test, also known in statistics as classification function. Sensitivity measures the proportion of actual positives which are correctly identified as such Sensitivity and specificity are statistical...
, but less sensitive
Sensitivity and specificity
Sensitivity and specificity are statistical measures of the performance of a binary classification test, also known in statistics as classification function. Sensitivity measures the proportion of actual positives which are correctly identified as such Sensitivity and specificity are statistical...
.
External links
- Puddle sign - fpnotebook.com.
- Puddle test (discussion in relation to EBM) - bmj.com