Palpatory assessment of an adult with abdominal pain is almost always concluded with an internal examination (rectal and/or vaginal examination). The internal examination can provide information on relevant intra-abdominal and retroperitoneal structures, such as the rectum, bladder, prostate, uterus, parametrium, the presacral space, and the deepest lying point of the peritoneum – the pouch of Douglas. Internal examination may be supplemented by bimanual examination [Figure 22].
Figure 22
A description of the rectal examination can be found in the section “specific examination techniques”.
For vaginal examination, refer to “The Gynaecological Examination”.