Exam

Shifting Dullness Test

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Shifting Dullness Test

  • Indication
  1. Confirming presence of Ascites
  • Test Limitations
  1. False Positive Test
    1. Mesenteric fat
    2. Feces in bowel
  2. Decreased sensitivity in Obesity
  3. Requires at least 500 cc of ascitic fluid
  • Technique
  1. Patient lies supine
  2. Percuss from tympanic bowel down to line of dullness
    1. Mark dullness line with a pen
  3. Patient turns onto side
  4. After 1 minute, re-mark line of dullness
  • Interpretation
  1. Considerable shift in line of dullness suggests Ascites