Traditionally, for the purposes of examination the abdomen has been split into four quadrants or nine regions as shown in Fig 1 below [1-3].
Fig. 1 Traditional abdominal examination regions
Fig 2 Simplified abdominal examination regions
It is important to gently palpate each of these areas, looking at the patient’s face for signs of pain, before proceeding to deep palpation.
On examination, note any tenderness or guarding, for example, tenderness to light palpation in the suprapubic area but without signs of guarding.
It is important to reassess the abdomen regularly as serial examinations by the same physician may reveal worsening pathology, e.g. peritonitis.
Do not forget to check for organomegaly as this is an important part of the abdominal examination.
Learning bite
Careful and serial clinical assessment of the abdomen is a key aspect of a patient’s ED management.