- Case Report
- Open Access
Woman with abdominal distention
© Springer-Verlag 2010
- Received: 19 February 2010
- Accepted: 13 April 2010
- Published: 8 June 2010
An 86-year-old woman presented to the Emergency Department after falling and being unable to get up. Her physical exam revealed massive abdominal distention and spider angiomata suspicious for possible ascites.
Materials and methods
The treating physician performed a bedside ultrasound that showed a discrete echogenic mass without evidence of ascites that was subsequently confirmed on computed tomography of the abdomen and pelvis.
The utility of bedside ultrasound in the diagnostic evaluation of abdominal distention and possible ascites is discussed.
- Emergency ultrasound
- Critical ultrasound
- Ovarian tumor
Several disease processes can mimic ascites including large pelvic masses, bowel obstruction, hepatic metastases, and massive hepatosplenomegaly. Attempted paracentesis in patients with these conditions could be catastrophic. While the physical exam can be helpful, it is neither sensitive nor specific for the presence of ascites [1, 2]. Prior research has suggested improved efficacy with the use of ultrasound prior to paracentesis [3, 4]. This case highlights the utility of bedside ultrasound in the diagnostic evaluation of abdominal distention and the importance of confirming ascites prior to paracentesis.
Conflict of interest
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- So CS, Schiedermayer D (2000) Pseudoascites in the clinical setting: avoiding unwanted and futile paracenteses. WMJ 99(6):32–34PubMedGoogle Scholar