Palpation of the stomach

This is an excerpt from Clinical Guide to Surface Palpation 2nd Edition With HKPropel Online Video, A by Michael Masaracchio & Chana Frommer.

Stomach

Positions

• Patient: supine, with a pillow under the knees
• Clinician: standing, on the left side of the patient, facing the head of the table

Instructions

• With the left hand, identify the medial aspect of the stomach (along the lesser curvature) just below the xiphoid process.
• Use the right hand to identify the lateral aspect (along the greater curvature) along the left lateral abdominal region.
• You should feel a broad firm structure through the rib cage.

Note

A radiographic classification has been developed to assess the shape of the stomach.¹⁴

• Hypertonic stomach: shaped like a steer’s horn, increased tone, empties in 2 to 3 hours
• Orthotonic stomach: shaped like the letter J, normal tone, empties in 3 to 4 hours
• Hypotonic stomach: shaped like the letter U, decreased tone, empties in 4 to 5 hours
• Atonic stomach: shaped like the letter U, no tone, empties in 5 to 6 hours

Clinical Pearl

Clinicians can assess changes in symptoms by checking the mobility of the stomach in a medial-to-lateral and a superior-to-inferior direction.