Palpation of the bowel
The colon is often palpable in thin people, when loaded with faeces in constipation, or when distended in intestinal obstruction.
Examination should be performed systematically, for example:
- right iliac fossa - caecum
- right lumbar region - ascending colon
- epigastrium and umbilical regions - transverse colon
- left lumbar region - descending colon
- left iliac fossa - sigmoid colon
In the lumbar regions, a bimanual technique is recommended, the left hand placed behind the loin, in line with the right.
Bowel is generally smooth, ill-defined, and sausage shaped with some side to side mobility. Unlike other masses, its contents can often be indented, especially in constipation. Rarely, a colonic tumour can be felt, particularly in the caecum, where masses may grow to a large size before causing symptoms.
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