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Renal Exam

Abdominal Inspection

November 28th, 2019


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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