• Ayşe Sena Çalış, Esra Kaya, Lijana Mehmetaj, Büşra Yılmaz, Elif Nurdan Demir, Derya Öztuna, Evren Üstüner, Halil İbrahim Açar, Serhat Tokgöz, Muzaffer Akkoca, and Mehmet Ayhan Kuzu.
• Medical Student, Ankara University School of Medicine, Ankara, Turkey.
• Turk J Surg. 2019 Dec 1; 35 (4): 309-313.

ObjectivesMedical textbooks suggest that the frequency of bowel sounds may be altered by performing auscultation after palpation or percussion. We hypothesize that the frequency of bowel sounds is not affected by the order of abdominal examination.Material And MethodsBoth healthy volunteers (n= 80) and patients (n= 100) were enrolled in this crossover randomized study. Two different examination orders, one as inspection, palpation, percussion, auscultation (IPPA) and the other order as inspection, auscultation, palpation, percussion (IAPP) were used by two observers, one of which was blinded to the order of the physical examination and only performed auscultation. Bowel motilities of 40 participants were analyzed with duplex Doppler USG by a radiologist. The effects of changing the order of abdominal examination and palpation-percussion maneuvers on the frequency of bowel sounds were evaluated.ResultsGender distribution was similar between the healthy patients and controls, and mean age of the entire study population was 47 (18-60) years. Differences between the mean bowel sound frequencies for abdominal examinations in order IPPA-IAPP versus IAPP-IPPA were evaluated for both healthy subjects and the patients. There were no differences between the first and second listening, nor were there differences between examinations performed in either order. Duplex Doppler Ultrasonographic (USG) assessments were performed on 20 healthy subjects and 20 patients before and after palpation and percussion; there were no statistically significant differences between the two listenings (p= 0.694).ConclusionAccording to both abdominal examinations and Doppler USG, the order of auscultation, whether performed before or after palpation or percussion, did not change the frequency of bowel sounds in this subject population.Copyright © 2019, Turkish Surgical Society.

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