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The abdominal examination is a cornerstone of clinical medicine, serving as a critical tool in diagnosing various gastrointestinal (GI) diseases. It involves a systematic approach that includes inspection and auscultation, each with distinct yet complementary roles in assessing the abdomen. This article will delve into these two primary methods healthcare professionals use to examine the abdomen.
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To promote clear communication, for instance, about the location of a patient's abdominal pain or a suspicious mass, anatomists and clinicians typically use imaginary lines to categorize the abdominopelvic cavity into either four quadrants or nine regions to identify organs in the cavity.
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Assessment of Child Anthropometry in a Large Epidemiologic Study
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Reference Values for Abdominal Circumference in Premature Infants.

Héléna Setruk1, Erika Nogué2, Aurélie Desenfants3

  • 1Department of Neonatal Medicine, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France.

Frontiers in Pediatrics
|March 3, 2020
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Summary

This study developed reference charts for abdominal circumference (AC) and the AC to head circumference (AC/HC) ratio in premature infants. The AC/HC ratio is a more reliable indicator than AC alone for diagnosing abdominal distention and feeding intolerance.

Keywords:
abdominal circumferenceabdominal distentionfeeding intolerancenecrotizing enterocolitispremature neonate

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Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Medical Statistics

Background:

  • Abdominal distention is a common, yet subjective, indicator of feeding intolerance in premature newborns.
  • Objective criteria are needed to standardize the assessment of abdominal distention in this vulnerable population.

Purpose of the Study:

  • To create reference charts and smoothed percentiles for abdominal circumference (AC) and the AC to head circumference (AC/HC) ratio.
  • To establish objective measures for assessing feeding tolerance and abdominal distention in premature infants (24-34 weeks gestational age).

Main Methods:

  • Collected weekly abdominal circumference (AC) and head circumference (HC) measurements in 373 premature infants.
  • Utilized the LMS method to model AC and AC/HC charts, excluding infants with congenital abnormalities or signs of distention/intracranial issues.
  • Employed mixed-effects linear models to analyze changes in AC and AC/HC over time.

Main Results:

  • Generated reference curves for AC and AC/HC based on gestational and postnatal age.
  • Found that gestational age, postnatal age, singleton status, and respiratory support significantly influenced AC and AC/HC.
  • Observed a significantly higher AC/HC ratio in infants with abdominal distention (0.95) and necrotizing enterocolitis (0.98) compared to those without (0.91).

Conclusions:

  • The developed AC and AC/HC reference charts can aid in evaluating feeding tolerance in premature infants.
  • The AC/HC ratio is a more sensitive and relevant metric than AC alone for objectively diagnosing abdominal distention in neonates.