• Clinical analysis of abdominal pain
  • Injuries of the abdomen
  • The study of the stomach is divided into General, the study of the state of organs and tissues of the abdomen, and private - a special study of separate organs of the abdominal cavity. General study of the abdomen should be performed in each patient and to forego private. For General studies belly use of clinical methods (reparametrize, inspection, percussion, auscultation, palpation), and some special techniques (puncture, peritoneoscopy, pneumoperitoneum, clinical analysis, pain localized in the abdomen).
    Reparametrize. For orientation in topographical relations of the abdominal cavity (see) and descriptions of the results of the study of the abdomen of the patient share in the region (see the Abdominal wall). Abdominal circumference was measured at the level of the navel.
    Examination of the abdomen are produced in vertical and horizontal position of the patient. At the same time paying attention to the size, the shape of the abdomen, the movement of the abdominal wall. Belly increases in obesity, flatulence, tumors, cysts. The asymmetry of the abdomen is observed in a significant increase in the abdominal cavity, encysted exudate, hernias, bloating separate loops of intestine, with symptoms of obstruction of the intestine. Visible ripple in the abdomen is defined in the epigastric region hypertrophy of the right ventricle of the heart, pulsation of the liver and abdominal aorta. Obesity navel involved, when ascites protrudes with flatulence-is the smoothed. When bleeding in the pancreas and the rupture of the uterine tube, due to an ectopic pregnancy, the navel may be bluish coloring. If the problem circulation in the pool portal vein or inferior Vena cava on the front surface of the abdomen visible network of subcutaneous veins.
    Percussion belly. All over the surface of the abdomen is determined tympanic tone, due to the presence of gas in the gastrointestinal tract. For topographical percussion apply the most weak blows directly with your finger (on Obraztsov). Percussion belly in various provisions of the patient helps to determine the presence of free liquid in an abdominal cavity. The presence of tympanic tone of the liver shows perforation of hollow organs (stomach, intestines).
    Auscultation of the abdomen. The sounds in the abdominal cavity arise independently and can be triggered artificially palpation, for example the sound of splashing in the stomach (see). Auscultation of the abdomen listen to various noises associated with promotion of chyme, peristalsis of intestines. They are missing paralytic condition of intestines. The friction noise peritoneal you can hear when perihepatitis, periplaneta, sometimes with tuberculous peritonitis.
    Palpation of the abdomen is the main, leading method in the study of the abdominal cavity and the abdominal wall is sometimes superficial and deep. Usually start with the surface (estimated) palpation. The patient should lie on his back on the medical couch with his head bowed, arms stretched out along the trunk. If the patient is examined in bed, his legs should not Balk at the foot end. The physician should sit to the right of the patient, in the chair, positioned on the same level with the couch or bed. The hands of the doctor should be warm and with short hair, nails. If the patient has no complaints about pains in the abdomen, palpation, you can start with any area; if there are complaints on pain in the abdomen start with palpation areas where the patient does not feel pain. When superficial palpation is possible to identify protective muscle tension, pain, increase of the authority, the presence of a tumor, hernia, a divergence of recti, peritoneal symptom.
    Methodical bases sliding deep palpation of the abdomen created B. N. Obraztsov. The method gives an opportunity to probe the majority of the abdominal cavity. The basis of this method are dipping fingers deep into the abdominal cavity through the veils of the abdominal wall, pressing authority to solid back wall, and sliding his fingers perpendicular to the axis of the organ or region. The success of the study of abdominal cavity organs depends on compliance with certain once and for all established order of feelings: the sigmoid colon, blind, end-iliac segment, vermiform process, upstream and downstream parts of the colon, transverse colon, stomach, liver, pancreas, spleen and kidneys. Using palpation you can get important information on anatomical changes and functional disorders of organs.
    Puncture belly produced in the presence of ascites (see).
    Laparoscopy - see Peritoneoscope.
    Pneumoperitoneum - see Pneumoperitoneum.