Abdominal Inspection
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.
Common Abdominal Surgical Scars
- AMidline laparotomy: xiphoid process to above or below the umbilicusMost abdominal procedures
- BParamedian: either side of the midlineLateral structures - kidney, adrenals, spleen
- CSubcostal: diagonally and parallel to the costal margin on either side.Gallbladder, biliary tract, spleen
- DChevron: bilateral subcostal incision meeting in the midlineGastrectomy, B/L adrenalectomy, liver surgery
- ELoin: transverse, from lateral mid-abdomen to flankKidneys
- FMcBurney’s: oblique incision made two thirds of the way fromthe umbilicus to the right anterior superior iliac spine.Appendicectomy
- GLanz: transverse incision across McBurney’s pointAppendicectomy (better scar healing)
- HPfannenstiel: 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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