Shifting Dullness

How to Perform

With the patient supine, percuss from the umbilical region outward toward each flank, marking the point where the note changes from tympanic to dull. Then have the patient roll onto one side, wait a few seconds, and percuss again. A positive sign is that the level of dullness shifts — the previously dull uppermost flank becomes tympanic, and the dullness moves to the now-dependent side.

How to Interpret