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Puddle Sign
Aka: Puddle Sign
- Indication
- Detects Ascites down to 120 cc of free fluid
- Technique
- Patient lies prone for 5 minutes
- Patient then rises onto elbows and knees
- Apply stethoscope diaphragm to most dependent Abdomen
- Examiner repeatedly flicks near flank with finger
- Continue to flick at same spot on Abdomen
- Move stethoscope across Abdomen away from examiner
- Sound loudness increases at farther edge of puddle
- Sound transmission does not change when patient sits
- Interpretation
- Augmentation of sound intensity suggests Ascites