Grading of Ascites

Grading of Ascites

• + Detectable only by careful examination.
• ++ Easily detectable but of relatively small volume.
• +++ Obvious ascites but not tense.
• ++++ Tense ascites.

Chronic ascites is associated with

• Umbilical hernia
• Puncture marks
• Striae
• Divarication of recti.

In ascites, usually flanks are dull and the centre of abdomen is resonant
In ovarian or pelvic tumors, the centre of abdomen is dull and flank are resonant.
However, in gross ascites and in large ovarian tumors, both the flanks and the centre of abdomen may be dull on percussion.