Abdominal distention

Background

• Defined as: diffuse swelling or enlargement of the abdomen.
  • It can also apply to the sensation of elevated abdominal pressure and volume.

Clinical Features

Ascites secondary to cirrhosis.

• Diffuse swelling or enlargement of the abdomen (or the sensation of such)

Differential Diagnosis

Abdominal distention

• Obesity
• Intestinal obstruction
• Pregnancy
• Ascites
  • Cirrhosis
  • Malignancy
  • Heart failure
  • Tuberculosis
• Spontaneous bacterial peritonitis
• Peritoneal dialysis-associated peritonitis
• Distended bladder / Acute urinary retention
• Constipation / fecal impaction
• Large tumor(s) (e.g. ovarian, lymphoma)
• Organomegaly

Evaluation

• May be obvious on physical exam (e.g. obesity)
• Consider ultrasound as a first test (e.g. obesity vs. ascites)
• If unsure, consider CT abdomen

Management

• Depends on underlying etiology.

Disposition

• Depends on underlying etiology.