Abdominaldistension

Abdominal distension is the outward expansion of the abdomen, producing increased abdominal girth. It is a symptom rather than a disease and may be accompanied by fullness or early satiety. Distension is distinguished from bloating, a subjective sensation, by measurable abdominal enlargement.

Causes fall into several broad categories: excess gas or stool in the gut; intra-abdominal fluid such as ascites; enlargement of abdominal organs or a mass; obesity; and pregnancy. Common etiologies include ileus, bowel obstruction, constipation, ascites (often from liver disease or heart/kidney failure), tumors, and inflammatory or infectious processes.

Physical findings depend on the cause. Gas and stool often yield a tympanic abdomen; ascites may show shifting dullness or a fluid wave; a mass or organomegaly may be felt. Red flags include sudden severe pain, fever, vomiting, hypotension, or peritoneal signs. Evaluation relies on history, exam, labs, and targeted imaging.

Ultrasound is frequently the first test to detect ascites, obstruction, or masses. Plain radiographs can reveal bowel distension or air-fluid levels, and CT provides detailed anatomy when needed. Paracentesis is diagnostic and therapeutic for ascites.

Management targets the underlying cause. Obstruction may require bowel rest and decompression; ascites is treated with sodium restriction, diuretics, and paracentesis for large volumes; constipation with laxatives; infections with appropriate therapy. Recurrent distension warrants multidisciplinary assessment.

Prognosis depends on the underlying disorder. Distension often improves with treatment of the cause, but some etiologies carry significant morbidity.