JAMA. 1904;XLIII(12):816-817. doi:10.1001/jama.1904.02500120052008.
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Although free fluid in the peritoneal cavity is ordinarily recognizable with ease, other conditions may cause similar symptoms. On the one hand, such fluid may, in consequence of adhesions or of gaseous distention, give rise to an asymmetrical area of dullness, while its mobility on change of position may be interfered with On the other hand, obese or edematous abdominal walls yield a sort of undulation on percussion, while properitoneal abscesses or lipomata, tumors of the intestinal wall, or deeply seated abdominal neoplasms or cystic tumors of the abdominal viscera may be a source of error in diagnosis. The greatest difficulty of differentiation, however, is encountered in connection with a condition described by Dr. L. Tobler1 as pseudo-ascites, which is dependent on the presence of fluid in distended small intestine with an elongated mesentery. The affection was observed in children between two and one-half and nine years of age, and


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