Physical Exam

Abdomen Percussion

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Video coming September 2026

How to Perform

Using the same finger-on-finger technique as chest percussion, percuss systematically across all four quadrants of the abdomen, comparing the note from area to area. Note where the percussion note is tympanic and where it is dull, and map the borders of any dullness.

How to Interpret

Hepatomegaly

Liver span enlarged on percussion (≥10 cm in the midclavicular line)

Rule in

Not helpful

Rule out

Not helpful

Evidence:Limited

References

Joshi R, Singh A, Jajoo N, Pai M, Kalantri SP. Accuracy and reliability of palpation and percussion for detecting hepatomegaly: a rural hospital-based study. Indian J Gastroenterol. 2004 Sep-Oct;23(5):171-174. PMID: 15598999.
Kuppusamy S, Gillatt D. Managing patients with acute urinary retention. Practitioner. 2011 Apr;255(1739):21-23. PMID: 21789984.
Tarasconi A, Coccolini F, Biffl WL, et al. Perforated and bleeding peptic ulcer: WSES guidelines. World J Emerg Surg. 2020 Jan 7;15:3. doi:10.1186/s13017-019-0283-9. PMID: 31921329.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.