Ascites: Shifting Dullness - Clinical Examination

The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.
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[@trespasser121]

I use this technique to check watermelons for ripeness.

[@suvilevi9211]

Bruh

[@CDubb442]

Explain friend

[@firmbutton6485]

Best video out there on Ascites shifting dullness.

[@DrSyl]

Super helpful, thanks!

[@thuthuaung7626]

What a brilliant video!!

[@StaceyCaryl]

thank you!

[@lumbiwemwanangono8954]

Thank you so much...
I finally hot it

[@kishouarima6334]

Thanks

[@ImTheCookieMonster95]

THANK YOU

[@victorajwang5889]

Awesome

[@13nurisahbintigindouk90]

Super helpful