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Palpation of the stomach

This is an excerpt from Clinical Guide to Surface Palpation 2nd Edition With HKPropel Online Video, A by Michael Masaracchio & Chana Frommer.

Stomach

Stomach

Positions

  • Patient: supine, with a pillow under the knees
  • Clinician: standing, on the left side of the patient, facing the head of the table


Instructions

  • With the left hand, identify the medial aspect of the stomach (along the lesser curvature) just below the xiphoid process.
  • Use the right hand to identify the lateral aspect (along the greater curvature) along the left lateral abdominal region.
  • You should feel a broad firm structure through the rib cage.


Note

A radiographic classification has been developed to assess the shape of the stomach.14

  • Hypertonic stomach: shaped like a steer’s horn, increased tone, empties in 2 to 3 hours
  • Orthotonic stomach: shaped like the letter J, normal tone, empties in 3 to 4 hours
  • Hypotonic stomach: shaped like the letter U, decreased tone, empties in 4 to 5 hours
  • Atonic stomach: shaped like the letter U, no tone, empties in 5 to 6 hours


Clinical Pearl

Clinicians can assess changes in symptoms by checking the mobility of the stomach in a medial-to-lateral and a superior-to-inferior direction.