Abdominal Sounds


60 year old woman with constipation of three months

Patient Chart

A 60 year old woman with constipation of three months duration. Her exercise tolerance has been decreased. She has coarse, rough skin.

Physical Exam


Blood pressure is increased. Pulse rate is 80 bpm. Swollen ankles. Lung sounds are normal.


Chest x-ray normal.
Low level of thyroid function.



Auscultation:




Diagnosis
What is your diagnosis?