Doctors palpate the abdomen to check certain organs and feel for atypical masses or tenderness. Palpating the abdomen is often part of an abdominal physical examination.
A doctor may perform a physical examination of the abdomen if a person has pain, bloating, enlarged organs, or lumps and masses in the abdominal area.
This article examines what abdominal palpation is and why doctors perform it. It also discusses palpation techniques, what the results could mean, and how light and deep palpation differ.
An abdominal examination involves checking the
A doctor typically conducts a physical abdominal examination in the following order:
- Inspection: This involves a visual examination of the abdomen, noting its shape, masses, skin abnormalities, and the movement of the abdomen while breathing.
- Auscultation: A doctor uses a stethoscope to check for altered bowel sounds, sounds relating to organs moving against the membrane lining the abdominal cavity, and vascular sounds resulting from turbulent blood flow.
- Percussion: Doctors tap their fingers or hands quickly against parts of a person’s abdomen. They do this to locate the edges of organs, identify their shape and position, and determine whether an organ is solid or filled with gas or fluid.
- Palpation: Doctors use their hands and varying pressure to feel for abnormalities.
When palpating the abdomen, a doctor assesses the abdominal organs, noting their size, shape, and consistency, and looks for muscle spasms, tenderness, masses, and fluid.
During an abdominal examination and palpation, a doctor
- Wash hands with soap and water or use an alcohol-based sanitizer.
- Identify the person, take their consent, and explain the steps of the examination.
- Ask the individual where they are experiencing pain.
- Position the person lying down on their back with a pillow under their head and their arms to their sides.
- Ensure the abdominal area is visible.
- Complete the three stages of palpation, including light palpation, deep palpation, and organ palpation in all abdominal areas. Begin in the areas furthest away from the pain.
- Use a one- or two-handed technique to detect abnormalities and note any areas of concern.
Sometimes, a person may tense their abdominal muscles due to being nervous, in pain, or due to the temperature of the room or hands of the healthcare professional conducting the examination. In these circumstances, a doctor may ask the individual to take a deep breath to relax the muscles or to bend the knees up, as this helps relax the abdominal muscles.
Doctors palpate the abdomen to determine the potential cause of abdominal pain and bloating or to detect masses. It can be a valuable technique for guiding further investigation and observing a person’s response to the placement of pressure on specific areas.
Doctors may look for signs or symptoms such as:
- crepitus, a crunching sensation that air or fluid within the tissues produces
- lipomas, a fatty tumor
- hernias
- masses
- pain
- tenderness
- irregularities of the liver, gallbladder, and spleen
- renal masses
- spasms or rigidity of abdominal muscles
- ascites, or fluid buildup in the abdomen that may cause swelling
The location of masses and tenderness may relate to organs in that area. For example, some of the following signs and symptoms
- Distended abdomen: The abdomen becoming atypically swollen outward could result from:
- a small bowel obstruction
- tumors
- masses
- an enlarged liver
- an enlarged spleen
- cancer
- constipation
- pregnancy
- Atypical masses: A mass could indicate a colon tumor, ovarian cyst, uterine fibroids, or ectopic pregnancy. Lumps in the abdomen may also indicate a hernia, such as:
- an umbilical hernia
- a ventral hernia
- a femoral hernia
- an abdominal aortic aneurysm
- inguinal hernia, when part of the abdominal cavity pushes into a part of the body called the inguinal canal
- Abdominal tenderness: Tenderness in any of the regions of the abdomen could signal inflammation of the organs underneath. For example, tenderness on the left lower side could indicate diverticulitis in older people, and tenderness on the right lower side could be appendicitis.
Doctors require further tests, such as blood tests and imaging tests, to confirm a diagnosis because many of these conditions share similar symptoms.
Doctors use two types of palpation when examining a person, relating to the degree of pressure they are exerting with their hands. These are called light palpation and deep palpation.
Doctors use light palpation to feel for surface abnormalities and perform the procedure with one hand. They gently press the skin using their finger pads. They assess the area for:
- temperature
- tenderness
- texture
- elasticity
- moisture
- pulsations
- masses
Deep palpation involves a doctor pressing down on the skin to around
- shape
- size
- symmetry
- tenderness
- mobility
Doctors perform abdominal palpation as part of an abdominal exam. They use light and deep pressure to systematically feel each section of a person’s abdomen, noting abnormalities or masses.
Palpation is an initial examination. The findings from palpating the abdomen may lead to doctors ordering diagnostic testing, such as blood tests or imaging tests.