Describe the Examination of Abdomen ?

The contour of abdomen is to be recorded. Normally the abdomen is scaphold in sharp in a young adult. In case of fullness and bulge presence of ascites is to be ruled by percussion (shifting dullness). Any organomegaly is to be noted, especially for enlargement of liver and spleen. A soft mildly enlarged liver is better demonstrated by light percussion as it may be missed during palpation. Unless the spleen enlarges more than double its size spleenic tip may not be palpable. Hence, in case of suspected enlargement obliteration of spleenic resonance beyond mid axillary line is expected.

Kidneys are better palpated by applying pressure by one hand at renal angle and palpating kidney by other hand on anteriority abdominal wall. Between both hands an enlarged kidney or a renal mass can be felt well and pushed backward and forward showing its ballotability. The detection of an enlarged kidney in case of hypertension can be important and poycystic disease of kidney must be ruled out.
In case of aneurysnl a pulsatile mass in the midline of abdomen can be often palpated. When two fingers are placed by the side of such as a systolic expansile movement is well demonstrated.

In elderly patient a saprapubic mass dull on percussion is caused by enlarged and overdistended bladder due to enlarged prostrate or bladder neck obstruction. Pulmonary hypertension can be secondary to unsuspected cirrhosis of liver.