symptoms of Ascites
Mild ascites is hard to notice, but
severe ascites leads to abdominal
distension. Patients with ascites
generally will complain of progressive
abdominal heaviness and pressure as
well as shortness of breath due to
mechanical impingement on the
diaphragm.

Ascites is detected on physical
examination of the abdomen by
visible bulging of the flanks in the
reclining patient (“flank bulging”),
“shifting dullness” (difference in
percussion note in the flanks that
shifts when the patient is turned on
the side) or in massive ascites with a
“fluid thrill” or “fluid wave” (tapping
or pushing on one side will generate
a wave-like effect through the fluid
that can be felt in the opposite side
of the abdomen).