GOVT.

UNANI MEDICAL COLLEGE GANDERBAL , KASHMIR

DEPARTMENT OF MOALAJAT ( MEDICINE )

ABDOMINAL PERCUSSION
Introduction
❖Percussion is a method of tapping body part with fingers , hands or small instrument as a part of physical examination .
❖It is done to determine size , consistency & border of body organs , the presence or absence of fluid in the body areas .
❖Types of percussion :
1. Topographic
2. Comparative
3. Auscultatory
Percuss outward from umbilicus

Mark the point where tympanic

note is converted to dull note due
to presence of fluid in case of
ascites ( > 1000ml ) patients.

Put your finger on same point &

tell patient to turn on opposite
Helpful in detection of moderate to massive ascites.
side

Fluid usually occupies the area of flanks & hypogastric

Wait for 15 sec region.

Percuss from umbilical region towards each flank on both

Percuss same point again , you side of abdomen & percuss suprapubic region also .
will hear tympanic note as fluid
has moved to opposite side In the presence of ascites , both flanks & suprapubic area
are dull to percuss due to collection of fluid.

Usually , signifies presence of tense

ascites Area of dullness appears horse shoe shaped with concave
upper border

Keep the patient in supine position

Asks the patient to keep ulnar border of

hand midway over the abdomen

Make a stroke with middle finger on

one side of abdomen while placing
other hands on opposite side where
you have to feel fluid thrill ( In ascites )

Can detect as little as 120 ml of ascitic fluid with in

abdomen.

This can be elicited either by percussion or by

Ausculto- percussion.

Keep the patient in knee elbow position & maintain

It for several minutes

Percuss around the umbilicus , presence of fluid

will result in dull note

Puddle sign Normal finding of liver percussion

Submitted by Supervised by
Sachin Bhagat Bums 3rd year Dr. Amanullah Haji ( Associate Professor )
Faizan Choudhary (Batch 2020-2021) Dr. Syed Shubrina ( Assistant Professor )
Baasit Shafi Dr. Shafia Mushtaq ( Assistant Professor )
Qurat Ali