ROSH Gastrointestinal Practice Exam

What physical exam finding is most consistent with abdominal distention in a patient with intestinal obstruction?

1. Cullen's sign

2. Dullness to percussion

3. Fluid wave

4. High-pitched bowel sounds

The correct answer is: High-pitched bowel sounds

High-pitched bowel sounds are a significant physical exam finding associated with abdominal distention due to intestinal obstruction. In cases of obstruction, bowel activity can become hyperactive as the body attempts to push contents past the obstruction, leading to the characteristic high-pitched or tinkling sounds audible during auscultation. This increased bowel activity often results in audible sounds that contrast sharply with the absence or decreased sounds in other conditions like ileus or bowel paralysis. The presence of high-pitched bowel sounds indicates that the intestine is still attempting to function despite the obstruction, and this finding can be an essential clue in diagnosing the underlying problem. Recognizing these sounds helps differentiate intestinal obstruction from other gastrointestinal issues, aiding in the appropriate management and treatment of the patient.