Abdominal Examination Clinical Guide

In the articles of this chapter, you will learn how to prepare a patient who presents with abdominal pain for an abdominal exam. We begin with a strategy for organizing your interaction with the patient, summarized by the SOAP acronym which stands for subjective, objective, assessment, and plan. Next, we dive into the subjective portion of the interaction and detail how to ask appropriate questions during the initial discussion by following the OLD CARTS acronym. We’ll also review patient-doctor differences you may encounter, such as cultural differences, and address how to bridge these gaps.

In these articles, we explore the objective portion of the SOAP acronym. We’ll lay out a plan for examining patients presenting with different types of abdominal pain and gastrointestinal symptoms. The abdominal exam is broken down into four components—inspection, auscultation, percussion, and palpation—and the first three components are reviewed in detail in this chapter.

In the articles of this chapter, you will learn about the fourth component of the abdominal exam—palpation of the abdomen. We’ll review how to organize the abdomen into regions or quadrants. We’ll also connect each region with its associated organ systems, which will help you make differential diagnoses for the patient presenting with abdominal pain. 

In these articles, you will discover how to perform specific and focused variations of the abdominal exam. Learn how to examine an acute abdomen, how to perform a digital rectal exam, and more. We’ll cover types of findings you may come across during an abdominal exam, how to identify peritoneal signs, and how to perform a thorough assessment of the genitalia and inguinal regions when a hernia is suspected.

In these articles, you will learn strategies for performing an abdominal examination on special populations. We’ll start with unique considerations for patients who are pregnant and move on to tips and tricks for performing the exam on children. You’ll also discover what to watch for in older patients presenting with abdominal complaints, who often present differently than their younger counterparts, making it easy to miss serious conditions.

The articles in this chapter will help you to apply all that you have learned in the previous chapters. You’ll work through unique case studies that demonstrate how to assess patients who are experiencing abdominal pain in each of the four quadrants of the abdomen. These articles finalize the SOAP concept by covering both the assessment and plan portions of the patient-doctor interaction.