Fluid wave tremor is one of the clinical physical examination methods, which is mainly used to examine the abdominal cavity for fluid accumulation.
The specific examination method: the patient is asked to lie down with legs flexed and the abdominal wall relaxed; the physician applies the palm of one hand to the abdominal wall on one side of the patient, and the other hand is slightly flexed with the four fingers together, tapping (or impacting with the fingertips) on the abdominal wall on the opposite side (to prevent the vibration of the abdominal wall itself from being transmitted to the opposite side and thus affecting the judgment, the ulnar edge of the palm of the other hand can be pressed against the midline of the umbilicus). If there is a large amount of fluid in the abdominal cavity, the palm of the hand against the abdominal wall has the sensation of being impacted by fluid fluctuations, i.e., fluctuation.
A significant fluctuating sensation is a positive sign, suggesting an intra-abdominal fluid volume of more than 3000 to 4000 ml. In addition, it is important to note that obese patients are prone to false-positive results on examination. If the amount of fluid in the abdominal cavity is small to moderate, a false-negative result is easily obtained, and this test is not as sensitive as a mobile turbid tone.
Positive fluid wave tremor results are most commonly seen in cirrhotic decompensation or advanced hepatocellular carcinoma.