Mrs. Smith, age 62, comes in c/o abdominal discomfort and de…
Mrs. Smith, age 62, comes in c/o abdominal discomfort and decreased energy. You note that she has a very protuberant and tense appearing abdomen. There is tympany over the periumbilical area with dullness over the right and left sides when she is lying flat. When you turn her to her right side, the dullness shifts to the right. What is the possible cause of the shifting dullness?