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Dipping method of palpation

  • When significant ascites is present, the abdominal masses may be difficult to feel by direct palpation.
  • Using the hand placed flat on the abdomen, mould the hand according to the shape of the abdomen, the fingers are flexed at the metacarpophalangeal joints so as to displace the underlying fluid.
  • This will enables the fingers to reach a mass covered in ascitic fluid.
  • This method should be used to palpate an enlarged liver or spleen with ascites.
  • Sudden displacement of liquid gives a tapping sensation over the surface of liver or spleen that is similar to patellar tap. 
  • For eliciting this, place the hand flat on abdomen and make quick dipping movements.