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Approaching a patient with abdominal distension requires a thorough history, physical examination, and appropriate investigations. Start by noting the onset, duration, and associated symptoms like pain, vomiting, or bowel changes. Assess dietary habits, recent surgeries, and medical history. During examination, observe the shape, symmetry, and presence of visible peristalsis. Percussion differentiates between fluid (ascites) and gas (intestinal obstruction). Palpation identifies tenderness or ma