what causes ABDOMINAL DISTENTION

Abdominal distention refers to increased abdominal girth - the result of the increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount of pressure. It may be localized or diffuse and may occur gradually or suddenly. Acute abdominal distention may signal life-threatening peritonitis or acute bowel obstruction.
Abdominal distention may result from fat, flatus, a fetus, intra-abdominal mass, hemorrhage, stool or fluid. Fluid and gas are normally present in the GI tract but not in the peritonial cavity. If fluid and gas can't pass freely through the GI tract, abdominal distention occurs. In the peritonial cavity, distention may reflect acute bleeding, accumulation of ascitic fluid, or air from perforation of an abdominal organ.
Abdominal distention doesn't always signal pathology. For example, in anxious patients or those with digestive distress, localized distention in the left upper quadrant can result from aerophagia - the unconscious swallowing of air. Generalized distention can result from ingestion of fruits or vegetables with large quantities of unabsorbable CHO, such as legumes, or from abnormal food fermentation by microbes.

Action Stat!!!

If the patient displays abdominal distention, quickly check for signs of hypovolemia, such as pallor, diaphoresis, hypotension, a rapid thready pulse, rapid shallow breathing, decreased urine output, and altered mentation. Ask the patient if he's experiencing severe abdominal pain or difficulty of breathing. Find out about any recent accidents, and observe him for signs of trauma, and peritonial bleeding, such as Cullen's sign or Turner's sign. Then auscultate all abdominal quadrants, noting rapid and high pitched, diminished, or absent bowel sounds. If you don't hear bowel sounds immediately, listen for at least 5 min in each of the 4 quadrants. Gently palpate the abdomen for rigidity. Remember that deep or extensive palpation may increase pain.
If you detect abdominal distention and rigidity along with abnormal bowel sounds and if the patient complains of pain, begin emergency interventions.
Place the patient in supine position, admin O2, and insert an I.V. catheter for fluid replacement. Prepare to insert nasogastric tube to relieve acute intraluminal distention. Reassure the patient and prepare him for surgery of course with doctors order.

Medical Causes

• abdominal cancer
• abdominal trauma
• cirrhosis
• heart failure
• irritable bowel syndrome
• large-bowel obstruction
• mesenteric artery occlusion (acute)
• paralytic ileus
• peritonitis
• small-bowel obstruction
• toxic megacolon (acute)

Nursing Consideration

• position the patient comfortably, using pillows for support
• if the patient has flatus, place him on his left side to help flatus escape
• if the patient has ascites, elevate the head of the bed to ease his breathing
• insert a nasogastric tube for bowel compression as doctors ordered; monitor amount and type of drainage
• administer drugs to relieve pain as doctors ordered, and offer emotional support
• prepare the patient for diagnostic test, such as abdominal x-rays, endoscopy, laparoscopy, ultrasonography, computed tomography scan or, possibly, paracentesis
• prepare the patient for surgery, if necessary

Patient Teaching

• teach the patient to use slow deep breathing to help relieve abdominal discomfort
• if the patient has an obstruction or ascites, tell him which foods and fluids to avoid
• empahasize the importance of oral hygiene to prevent dry mouth
• explain the underlying disorder and treatment plan.

related post:
abdominal rigidity
abdominal pain
abdominal masses location
abdominal masses
detecting ascites
abdominal distention>>>>>> abdominal masses