Exploración abdominal

Physical Examination of the Abdomen 1. Inspection • Observe the shape, volume, and symmetry of the abdomen. • Look for scars, hernias, respiratory movements, collateral circulation, visible peristalsis, masses, or skin lesions. 2. Auscultation • Performed before palpation and percussion (to avoid disturbing bowel sounds). • Assess bowel sounds (normal, increased, decreased, or absent). • Listen for vascular bruits (aorta, renal arteries, iliac arteries, femoral arteries). 3. Percussion • Evaluates the proportion of gas, fluid, and solid organs. • Normal sounds: • Tympany: predominates due to intestinal air. • Dullness: perceived over the liver, spleen, and masses. Clinical uses: Delineating organs: size of the liver and spleen. • Ascites: shifting dullness, ascites wave. • Free air: diffuse tympany. 4. Palpation • Superficial: tenderness, muscle resistance, superficial masses. • Deep: organs, masses, tender points (e.g., McBurney's point in appendicitis). • Assess for organomegaly (hepatomegaly, splenomegaly). • Look for signs of peritoneal irritation (guarding, rebound tenderness).