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Protuberant Abdomens (Table 11-9)
most common cause of a protuberant abdomen; thickens the abdominal wall, the mesentery, and the omentum; umbilicus may seem sunken
apron of fatty tissue that may extend below the inguinal ligaments
distention may be localized or generalized; causes a tympanitic percussion note
can be produced from certain foods
more serious causes are intestinal obstruction and adynamic (paralytic) ileus
true or false: in a protuberant abdomen distended by gas, distention becomes more marked in colonic than in small bowel obstruction
large, usually rises out of pelvis, and dull to percussion; air-filled bowel is displaced to the periphery
causes include ovarian tumors and uterine myomata; occasionally a distended bladder can be mistaken for this.
common cause of a "pelvic" mass
seeks the lowest point in the abdomen, producing bulging flanks that are dull to percussion; the umbilicus may protrude