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:
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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