Polycystic Disease

Inspection:

• abdominal bulge
• no cough impulse
• no scar

Palpation:

• organomegaly
• hepatomegaly
• smooth, firm, well demarcated border
• moves with respiration
• dull on percussion
• non tender
• 
  
• bilateral enlarged kidney
• ballotable
• vertical movement on respiration
• smooth and firm

look for evidence of renal failure

• uraemic complexion
• CAPD / AV fistula scar