Gastroenterology Book

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Shifting Dullness Test

Aka: Shifting Dullness Test
  1. Indication
    1. Confirming presence of Ascites
  2. Test Limitations
    1. False positive Test
      1. Mesenteric fat
      2. Feces in bowel
    2. Decreased sensitivity in Obesity
    3. Requires at least 500 cc of ascitic fluid
  3. Technique
    1. Patient lies supine
    2. Percuss from tympanic bowel down to line of dullness
      1. Mark dullness line with a pen
    3. Patient turns onto side
    4. After 1 minute, re-mark line of dullness
  4. Interpretation
    1. Considerable shift in line of dullness suggests Ascites

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