GIT

A. Inspection

1. Symmetry
2. Position of umbilicus
3. flanks
4. Any discolorations, ecchymosis
5. Movement with respiration
6. Hernial sites
7. Focal abdominal swellings or lump
8. Scar marks, dilated veins, sinuses
9. Visible pulsation
10. Visible peristalsis
 1. Deep palpation
B. Palpation 2. guarding rebound tenderness,
3. any lumps or swelling
4. Palpation for liver
Superficial palpation i. (if palpable how far from subcostal margin
in cm),
1. localized elevation of ii. feel for lower border (soft or firm,smooth
temperature or sharp)
2. all four quadrants - Feel of iii. liver surface (tender or non-tender, soft or
firm, smooth or nodular).
abdomen (Soft or firm or rigid),
5. Palpation for spleen,
3. any tenderness i. if palpable how far from subcostal margin
in cm,
ii. soft or firm tender or non tender,
iii. smooth or irregular surface
iv. Grading based on size
6. Bimanual palpation of kidney
C . Percussion
1. Abdominal percussion for shifting dullness
2. Percuss for upper border of liver dullness, and liver span
3. Percuss Traube's area for splenic dullness,
4. Percuss bladder to assess if it is full
D. Ascultation
1. Four quadrants for bowel sounds.
(Normally 6-7 splashing clinking sounds are heard ever)
2. renal bruit.
Just Above umbilicus, bilaterally
3. hepatic bruit
Over right upper quadrant
4. splenic bruit
and left upper quadrant
 ABN AE

Mortality after abd surgery

10 30 82
Survival rate
100 `80 45
Risk for developing complications
Less Moderate More
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