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Renal Exam
 
 

Abdominal Inspection

 
 
 
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Overview

Inspect the abdomen for skin changes, scars, distension or visible masses.

Abdominal Scars

Scars on the abdomen can suggest past surgery, trauma, burns and healed skin conditions.
  • Abdominal Scars
  • Common Abdominal Surgical Scars

  • A
    Midline laparotomy: xiphoid process to above or below the umbilicusMost abdominal procedures
  • B
    Paramedian: either side of the midlineLateral structures - kidney, adrenals, spleen
  • C
    Subcostal: diagonally and parallel to the costal margin on either side.Gallbladder, biliary tract, spleen
  • D
    Chevron: bilateral subcostal incision meeting in the midlineGastrectomy, B/L adrenalectomy, liver surgery
  • E
    Loin: transverse, from lateral mid-abdomen to flankKidneys
  • F
    McBurney’s: oblique incision made two thirds of the way fromthe umbilicus to the right anterior superior iliac spine.Appendicectomy
  • G
    Lanz: transverse incision across McBurney’s pointAppendicectomy (better scar healing)
  • H
    Pfannenstiel: long, convex incision along the suprapubic creaseLower GIT, urinary tract, reproductive organs incl. caesarean
  • Laparoscopy: 3-4 small incisions on the abdomen; one at the umbilicus.Laparoscopic procedures

Abdominal Distension

  • Interpretation

  • FatCentral obesity
  • FaecesLifestyle, age, obstruction, drugs, endocrine / neurological
  • FlatusIrritable bowel syndrome, mechanical or paralytic gut obstruction
  • FluidAscites, blood, pus, urine, bile, lymph, enteric contents
  • FoetusPregnancy
  • MassCancer, abscess, abdominal wall fibrosis
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