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.
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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