Gastro Exam
 

Abdominal Auscultation

 
 
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On this page:Bowel SoundsSuccussion Splash

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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