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.
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.