What is a positive shifting dullness test?

What is a positive shifting dullness test?

Shifting Dullness Positive test: When ascites is present, the area of dullness will shift to the dependent site. The area of tympany will shift toward the top.

What is dullness in ascites?

The shifting dullness refers to a sign, elicited on physical examination, for ascites. If, on percussion, the region of dullness shifts when the patient is turned from supine position to side-lying, they probably have fluid in the abdomen.

What does fluid wave indicate?

A positive fluid wave test indicates that there is a free fluid (ascites) in the abdomen. When one side of the abdomen is pressed, the other side may also be painful due to the transfer of the fluid in it.

When does shifting dullness occur in a physical exam?

Physical Examination Normally there is less than 75–100 ml of fluid in the peritoneal cavity. Ascites can be detected by eliciting shifting dullness when peritoneal fluid collection exceeds 500 ml. Fluid wave is positive in the presence of tense ascites; patients with tense ascites may also have concomitant lower extremity edema.

How is shifting dullness related to air fluid?

With the subject on his or her side, the examiner percusses again at the same point where tympany converted to dullness. If that spot is now tympanic, shifting dullness has been detected as a result of movement of the air-fluid boundary; this finding supports the presence of ascites.

Can a fluid wave be detected in supine position?

Clinical Notes The fluid wave test is of limited sensitivity because it requires sufficient fluid in the peritoneal cavity to make a wave. A fluid wave can be detected in the erect position in some patients when it is no apparent in the supine position.

What kind of test is a fluid wave test?

In medicine, the fluid wave test or fluid thrill test is a test for ascites (free fluid in the abdominal cavity). It is performed by having the patient (or a colleague) push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap.