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Related to Shifting dullness: Puddle sign, fluid wave, fluid thrill
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Shifting dullness was elicited and the flanks were dull.
This case was challenging because of the long duration, presence of constitutional symptoms, recent ingestion of traditional medicament, shifting dullness and dullness in the flanks on clinical examination, previous non-significant rectal biopsy, ascites revealed on ultrasound examination, and unhelpful laboratory investigations.
Physical examination showed a distended abdomen with a palpable right adnexal mass, shifting dullness, mild tenderness in the right lower quadrant, and normal bowel sounds.