Central Dullness in the Abdomen with Resonance in the Flanks

CLINICAL DIAGNOSTIC MANUAL

Central dullness in the abdomen with resonance in the flanks is a clinical finding that often indicates the presence of a mass or fluid collection in the abdominal cavity.

This sign is detected through abdominal percussion and suggests that the central region of the abdomen is occupied by solid or liquid content, while the flanks remain resonant due to the presence of intestinal gas.

Accurate identification of the underlying cause is essential for appropriate patient treatment and may involve various diagnostic tests.

Pathology	Symptoms and Clinical Signs	Suspicion Diagnosis	Confirmatory Diagnosis
Ascites	Abdominal distension, central dullness, peripheral edema, dyspnea	Clinical history, physical examination	Abdominal ultrasound, paracentesis with ascitic fluid analysis
Distended Gallbladder	Right upper quadrant pain, fever, jaundice, palpable mass	Clinical history, physical examination	Abdominal ultrasound, Abdominal and Pelvic CT scan
Pregnancy	Amenorrhea, nausea, abdominal distension, central dullness, urinary symptoms	Clinical history, physical examination, pregnancy test	Transvaginal or abdominal ultrasound
Massive Ovarian Cyst	Abdominal pain, abdominal distension, menstrual irregularities	Clinical history, gynecological examination	Transvaginal ultrasound, Abdominal and Pelvic CT scan
Abdominal Tumors	Abdominal pain, palpable mass, weight loss, anemia, intestinal obstruction	Clinical history, physical examination	Abdominal and Pelvic CT scan, biopsy
Pseudomyxoma Peritonei	Abdominal distension, abdominal pain, changes in bowel habits	Clinical history, physical examination	Abdominal and Pelvic CT scan, peritoneal fluid analysis
Bladder Hydrops	Suprapubic pain, urinary retention, abdominal distension	Clinical history, physical examination	Bladder ultrasound, cystoscopy
Abdominal Lymphoma	Palpable abdominal mass, fever, weight loss, night sweats, fatigue	Clinical history, physical examination, blood tests (LDH, CBC)	Biopsy of the affected lymph node, Abdominal and Pelvic CT scan, PET scan