Distended
Formal Definition
Abdominal distension: abnormal outward protrusion or enlargement of the abdomen, caused by gas, fluid (ascites), organomegaly, bowel obstruction, or other intra-abdominal pathology.
How It's Used on the Ward
"Belly is distended" or "distended abdomen" — a key physical exam finding that shifts the differential significantly.
Example
""Post-op day 3 after colectomy: abdomen progressively distended, tympanitic throughout, no bowel sounds. KUB shows air-fluid levels. Working diagnosis: ileus vs. early obstruction.""
Clinical Context
Distension has a classic mnemonic: the 5 F's — Fat, Fluid, Flatus, Feces, Fetus. Percussion differentiates: tympanic (gas/air) vs. dull (fluid/solid). Shifting dullness and a fluid wave confirm ascites. Distension in a post-op patient always prompts bowel obstruction workup. In the ICU, abdominal compartment syndrome (ACS) causes distension + organ dysfunction — bladder pressure >20 mmHg confirms.