Is Listening for Abdominal Bruits Useful in the Evaluation of Hypertension? FREE

J. M. Turnbull, MD, FRCP

[+] Author Affiliations

Reprint requests to Ottawa Civic Hospital, 1053 Carling Ave, Ottawa, Ontario, Canada K1Y 1J8 (Dr Turnbull).

The Rational Clinical Examination section editors: David L. Simel, MD, MHS, Durham Veterans Affairs Medical Center and Duke University Medical Center, Durham, NC; Drummond Rennie, MD, Deputy Editor (West), JAMA.

JAMA. 1995;274(16):1299-1301. doi:10.1001/jama.1995.03530160051033

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ABSTRACT

ABSTRACT | REFERENCES

TOWARD the end of an unusually busy clinic, a clinical clerk greets the final patient of the day, a man with a recently documented increase of his blood pressure. With all the enthusiasm that remains after 4 years of medical training, she compulsively listens for abdominal bruits. Almost surprised, she hears a soft systolicdiastolic epigastric bruit and is faced with the inevitable question—so what?

WHY IS THIS AN IMPORTANT QUESTION TO ANSWER? As we have gained insight into the origin and meaning of vascular bruits, detailed auscultation of the abdomen has become more common. Once detected, an abdominal bruit often is characterized according to pitch, timing, amplitude, and location in an effort to detect and document pathologic states, such as renovascular disease, splenic enlargement, hepatic cirrhosis, carcinoma of the pancreas and liver, splenic and hepatic vascular abnormalities, intestinal vascular insufficiency, and aortic disease. More recently, abdominal bruits have been documented

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