Evaluate Bowel Sounds

The patient is placed in a supine position. To perform auscultation of the abdomen, the examiner places the diaphragm of the stethoscope over the midabdomen and listens for bowel sounds. This technique is pictured in Figure 17-15.

Normal bowel sounds occur approximately every 5 to 10 seconds and have a high-pitched sound. If after 2 minutes no bowel sounds are heard, ''absent bowel sounds'' may be noted. The absence of bowel sounds suggests a paralytic ileus that results from diffuse peritoneal irritation. There may be rushes of low-pitched rumbling sounds, termed borborygmi, which are associated with hyperperistalsis. These sounds are similar to the sound of the word ''borborygmi'' itself. They are common in early acute intestinal obstruction.

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