Physical examination maneuver
Physical Exam
Shifting Dullness
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Video coming September 2026
How to Perform
With the patient supine, percuss the abdomen directly on skin from the umbilical region toward each flank and identify where tympany changes to dullness. Ask the patient to roll onto one side, wait briefly, then percuss the now-upper flank again. The test is positive if the boundary of dullness shifts toward the dependent side, causing the previously dull upper flank to become tympanitic.
How to Interpret
Showing 2 of 3 findings
Ascites
Shifting dullness positive
Rule in
Somewhat helpful
Rule out
Somewhat helpful
Evidence:Strong
Cirrhosis
Ascites present on examination
Rule in
Helpful
Rule out
Minimally helpful
Evidence:Strong