Tympany

Tympany is a medical term used to describe a drum-like percussion sound or distension of a hollow organ caused by gas, most commonly in the abdomen. The word derives from the Greek tympanon, meaning drum, and in clinical use refers to the characteristic resonant note heard when tapping on a gas-filled structure.

In clinical examination, tympany refers to the tympanic percussion note produced over distended gas-filled loops of bowel. Abdominal tympany is typically described as a hollow, resonant sound that can be detected across the abdomen. This finding helps differentiate gas distension from other causes of abdominal swelling, such as fluid or solid masses, which usually yield duller percussion notes.

Causes of abdominal tympany range from benign to emergent. Common factors include aerophagia (air swallowing), diets high in fiber or gas-producing foods, and mild, generalized gaseous distension. More significant causes include mechanical bowel obstruction or ileus, severe constipation, or other conditions that trap or generate gas within the intestinal tract. In some cases, tympany may be localized to a particular segment of bowel or generalized throughout the abdomen.

Diagnosis relies on physical examination augmented by imaging. Percussion and auscultation are standard, with radiographs or computed tomography often used to identify the presence and location of gas, assess for obstruction, and determine underlying etiologies.

Treatment is etiology-driven. Mild gaseous distension may require observation and supportive care, while bowel obstruction or ileus may necessitate decompression (for example, with a nasogastric tube), correction of electrolyte imbalances, and measures to alleviate contributing factors. Severe or unresponsive tympany requires prompt evaluation to prevent complications such as perforation or respiratory compromise.

Prognosis depends on the underlying cause. Gas distension due to benign causes generally has a favorable outlook, whereas obstructive or inflammatory processes demand timely management.