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Abdomen symetrically distended secondary to fluid build up in peritoneal cavity.
Note bulging flanks as fluid distributes to most dependent areas of abdomen. skin is also yellowed
due to hyperbilirubinemia.
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Ascites with Shifting Dullness: Ascitic fluid will flow to the most dependent portions of the abdomen.
The air-filled intestines will float on top of this liquid. The technique of shifting dullness makes use of
this relationship in order to detect the presence of ascitic fluid.