Physical examination

  • general: nutritional status, weight, hydration status, icterus, drowsiness, mood
  • inspection of the mouth and pharynx (especially candidiasis)
  • abdominal examination: surgical scars, herniation, peristalsis (absence of peristalsis and/or gurgling sounds in the case of ileus), signs of ascites (shifting dullness = position-dependent dullness during percussion, undulation = fluid wave induction in the flanks), distended stomach (clapotage = sloshing sound when the gastric region is pressed), liver enlargement, abnormal resistance, pain when pressure is applied, faecal impaction on rectal examination
  • fundoscopy/neurological examination if increased intracranial pressure or overstimulation of the vestibular system is suspected

Inspection of the vomit may provide additional information. Large amounts of food remnants indicate pyloric or duodenal obstruction or bowel obstruction. Faecal-smelling vomit indicates obstruction of the small intestines.