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In gastroenterology, the puddle sign is a physical examination maneuver that can be used to detect the presence of ascites. It is useful for detecting small amounts of ascites -- as small as 120 mL; shifting dullness and bulging flanks typically require 500 mL.〔Shah R. Ascites. eMedicine.com. URL: (http://www.emedicine.com/med/topic173.htm ). Accessed on: September 17, 2007.〕 The steps are outlined as follows:〔FamilyPracticeNotebook.com URL: (http://www.fpnotebook.com/GI41.htm ). Accessed on: March 14, 2008.〕 # Patient lies prone for 5 minutes # Patient then rises onto elbows and knees # Apply stethoscope diaphragm to most dependent part of the abdomen # Examiner repeatedly flicks near flank with finger. Continue to flick at same spot on abdomen # Move stethoscope across abdomen away from examiner # Sound loudness increases at farther edge of puddle # Sound transmission does not change when patient sits In relation to auscultatory percussion, the puddle sign is more specific, but less sensitive. ==See also== *Abdominal examination *Fluid wave test *Bulging flanks 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「puddle sign」の詳細全文を読む スポンサード リンク
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