The five causes of generalized abdominal distention (the ‘five Fs’) are fluid, flatus, faeces, fat & fetus.
× Uniform fullness of abdomen along with fullness of flanks indicates ascites. Presence of transversely stretched umbilicus (smiling umbilicus) favours ascites. It can be confirmed with sign of ascites like shifting dullness, hoarse shoe shape dullness & presence of fluid thrill.
× Sometimes, large mesenteric cyst or ovarian cyst may mimic ascites.
× Distention of abdomen due to flatus & faeces presents as waxing & wanning, non progressive abdominal distention.
× An excess of adipose visceral fat causes protrusion of abdomen due to central obesity. This body type is also known as ‘apple shaped’, as opposed to ‘pear shaped’ in which fat is deposited on the hips & buttocks.