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Gastro Exam
 
 
Gastro Exam
The gastrointestinal exam is used to assess patients for pathology affecting the gastrointestinal tract, hepatobiliary system or other abdominal organs.
The Patient
The Hands
The Arms
The Face
The Neck
The Chest
The Abdomen – Inspection
The Abdomen – Auscultation
The Abdomen - Palpation
The Groin
Digital Rectal Examination
 

Abdominal Auscultation

 
 

Overview

  • Auscultation for the character of the bowel sounds may reveal evidence of hyperactive or underactive bowels.

Bowel Sounds

    • How to Assess

      • Auscultate the abdomen for bowel sounds. First listen in one quadrant and if an abnormality is discovered then listen in each of the three other quadrants.
  • In order to be sure that bowel sounds are absent, it is important to listen for at least five minutes.

    • Interpretation

    • Gurgling sounds: movement of gas and fluid via peristalsisNormal
    • Borborygmi: loud rumbling sounds due to movement of air within the gutNormal
    • Hypoactive: diminished or absent bowel soundsPeritonitis, proximal obstruction, ileus, ischaemia
    • Hyperactive: extremely increased bowel soundsGastroenteritis, laxatives, IBD, bowel obstruction
    • Hollow, high pitched tinkles: similar to rain on a tin roof, due to liquid and gas under pressure within dilated gutCharacteristic of small bowel obstruction

Succussion Splash

  • In patients with gastric outlet obstruction, a succussion splash will be heard on percussion of the abdomen due to excessive fluid in the stomach.

    • How to Elicit

      • Auscultate the abdomen while rapidly tapping over the epigastrium, listening for a splashing sound.

    • Causes of Succussion Splash

    • Peptic ulcer
    • Ingestion of caustic chemicals
    • Pancreatitis
    • Crohn’s disease
    • Gastric polyp
    • Hypertrophic pyloric stenosis
    • Bezoar
    • Cancer - gastric, pancreatic, bile duct
    • Hydropneumothorax
Last updated on November 26th, 2019
 
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Associated Diseases
BETA

Gastric & Small Bowel
Crohn's Disease
Pancreatic
Gastric Cancer
Biliary Duct Adenocarcinoma
Pancreatic Cancer

Associated Drugs
BETA

Psyllium
 

Read More...
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