Gastroparesis physical examination: Difference between revisions
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{{Gastroparesis}} | {{Gastroparesis}} | ||
{{CMG}}; {{AE}} {{MSI}} | {{CMG}}; {{AE}} {{SSH}}; {{MSI}} | ||
==Overview== | ==Overview== | ||
[[Physical examination]] of patients with gastroparesis is usually remarkable for [[epigastric]] [[distension]] and [[tenderness]]. The presence of other findings on [[physical examination]] depends on the various cause of gastroparesis. | |||
==Physical Examination== | ==Physical Examination== | ||
*Physical examination of patients with gastroparesis is usually remarkable for epigastric | *[[Physical examination]] of patients with gastroparesis is usually remarkable for [[epigastric]] [[distension]] and [[tenderness]].<ref name="ParkmanHasler2004">{{cite journal|last1=Parkman|first1=Henry P.|last2=Hasler|first2=William L.|last3=Fisher|first3=Robert S.|title=American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis|journal=Gastroenterology|volume=127|issue=5|year=2004|pages=1592–1622|issn=00165085|doi=10.1053/j.gastro.2004.09.055}}</ref><ref name="pmid25667023">{{cite journal| author=Parkman HP| title=Idiopathic gastroparesis. | journal=Gastroenterol Clin North Am | year= 2015 | volume= 44 | issue= 1 | pages= 59-68 | pmid=25667023 | doi=10.1016/j.gtc.2014.11.015 | pmc=4324534 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25667023 }}</ref><ref name="ParkmanYates2011">{{cite journal|last1=Parkman|first1=Henry P.|last2=Yates|first2=Katherine|last3=Hasler|first3=William L.|last4=Nguyen|first4=Linda|last5=Pasricha|first5=Pankaj J.|last6=Snape|first6=William J.|last7=Farrugia|first7=Gianrico|last8=Koch|first8=Kenneth L.|last9=Abell|first9=Thomas L.|last10=McCallum|first10=Richard W.|last11=Lee|first11=Linda|last12=Unalp–Arida|first12=Aynur|last13=Tonascia|first13=James|last14=Hamilton|first14=Frank|title=Clinical Features of Idiopathic Gastroparesis Vary With Sex, Body Mass, Symptom Onset, Delay in Gastric Emptying, and Gastroparesis Severity|journal=Gastroenterology|volume=140|issue=1|year=2011|pages=101–115.e10|issn=00165085|doi=10.1053/j.gastro.2010.10.015}}</ref><ref name="PasrichaYates2015">{{cite journal|last1=Pasricha|first1=Pankaj J.|last2=Yates|first2=Katherine P.|last3=Nguyen|first3=Linda|last4=Clarke|first4=John|last5=Abell|first5=Thomas L.|last6=Farrugia|first6=Gianrico|last7=Hasler|first7=William L.|last8=Koch|first8=Kenneth L.|last9=Snape|first9=William J.|last10=McCallum|first10=Richard W.|last11=Sarosiek|first11=Irene|last12=Tonascia|first12=James|last13=Miriel|first13=Laura A.|last14=Lee|first14=Linda|last15=Hamilton|first15=Frank|last16=Parkman|first16=Henry P.|title=Outcomes and Factors Associated With Reduced Symptoms in Patients With Gastroparesis|journal=Gastroenterology|volume=149|issue=7|year=2015|pages=1762–1774.e4|issn=00165085|doi=10.1053/j.gastro.2015.08.008}}</ref><ref name="pmid25667022">{{cite journal |vauthors=Koch KL, Calles-Escandón J |title=Diabetic gastroparesis |journal=Gastroenterol. Clin. North Am. |volume=44 |issue=1 |pages=39–57 |year=2015 |pmid=25667022 |doi=10.1016/j.gtc.2014.11.005 |url=}}</ref> | ||
*The presence of other findings on [[physical examination]] depends on the various cause of gastroparesis. | |||
===Vital | ===Appearance of the patient=== | ||
*Patients with gastroparesis usually appear normal | |||
===Vital signs=== | |||
*Low-grade [[fever]] (in postviral idiopathic gastroparesis) | *Low-grade [[fever]] (in postviral idiopathic gastroparesis) | ||
| Line 20: | Line 21: | ||
===Skin=== | ===Skin=== | ||
* Dry skin (in severe [[dehydration]]) | * [[Xeroderma|Dry skin]] (in severe [[dehydration]]) | ||
* [[Raynaud's phenomenon]] (in [[Connective tissue disease|connective tissue disorder]]) | * [[Raynaud's phenomenon]] (in [[Connective tissue disease|connective tissue disorder]]) | ||
=== HEENT === | === HEENT === | ||
* Dry mouth (in severe [[dehydration]]) | * [[Xerostomia|Dry mouth]] (in severe [[dehydration]]) | ||
* Shrunken eyes (in severe [[dehydration]]) | * Shrunken eyes (in severe [[dehydration]]) | ||
===Neck=== | ===Neck=== | ||
*Neck examination of patients with gastroparesis is usually normal | *Neck examination of patients with gastroparesis is usually normal | ||
===Lungs=== | ===Lungs=== | ||
*Fine/coarse [[Rales|crackles]] upon auscultation of the lung bases (in [[Connective tissue disease|connective tissue disorder]]) | *Fine/coarse [[Rales|crackles]] upon [[auscultation]] of the lung bases (in [[Connective tissue disease|connective tissue disorder]]) | ||
===Heart=== | ===Heart=== | ||
* Cardiovascular examination of patients with gastroparesis is usually normal | * [[Cardiovascular]] [[examination]] of patients with gastroparesis is usually normal (S1 +S2 + 0) | ||
===Abdomen=== | ===Abdomen=== | ||
| Line 38: | Line 39: | ||
*[[Abdominal tenderness]] in the [[epigastric]] or periumbilical region | *[[Abdominal tenderness]] in the [[epigastric]] or periumbilical region | ||
*Succussion splash | *Succussion splash | ||
*[[Abdominal guarding|Guarding]] is absent | *[[Abdominal guarding|Guarding]] is absent | ||
=== Back === | === Back === | ||
* Back examination of patients with gastroparesis is usually normal | * Back examination of patients with gastroparesis is usually normal | ||
=== Genitourinary === | === Genitourinary === | ||
* Genitourinary examination of patients with gastroparesis is usually normal | * Genitourinary examination of patients with gastroparesis is usually normal | ||
=== Neuromuscular === | === Neuromuscular === | ||
| Line 50: | Line 51: | ||
=== Extremities === | === Extremities === | ||
* Extremities examination of patients with gastroparesis is usually normal | * Extremities examination of patients with gastroparesis is usually normal | ||
==References== | ==References== | ||
Latest revision as of 16:02, 20 February 2018
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Gastroparesis physical examination On the Web |
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Risk calculators and risk factors for Gastroparesis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]; Madhu Sigdel M.B.B.S.[3]
Overview
Physical examination of patients with gastroparesis is usually remarkable for epigastric distension and tenderness. The presence of other findings on physical examination depends on the various cause of gastroparesis.
Physical Examination
- Physical examination of patients with gastroparesis is usually remarkable for epigastric distension and tenderness.[1][2][3][4][5]
- The presence of other findings on physical examination depends on the various cause of gastroparesis.
Appearance of the patient
- Patients with gastroparesis usually appear normal
Vital signs
- Low-grade fever (in postviral idiopathic gastroparesis)
- Orthostatic hypotension (in diabetic gastroparesis)
Skin
- Dry skin (in severe dehydration)
- Raynaud's phenomenon (in connective tissue disorder)
HEENT
- Dry mouth (in severe dehydration)
- Shrunken eyes (in severe dehydration)
Neck
- Neck examination of patients with gastroparesis is usually normal
Lungs
- Fine/coarse crackles upon auscultation of the lung bases (in connective tissue disorder)
Heart
- Cardiovascular examination of patients with gastroparesis is usually normal (S1 +S2 + 0)
Abdomen
- Abdominal distention
- Abdominal tenderness in the epigastric or periumbilical region
- Succussion splash
- Guarding is absent
Back
- Back examination of patients with gastroparesis is usually normal
Genitourinary
- Genitourinary examination of patients with gastroparesis is usually normal
Neuromuscular
- Abdominal muscle wall rigidity
Extremities
- Extremities examination of patients with gastroparesis is usually normal
References
- ↑ Parkman, Henry P.; Hasler, William L.; Fisher, Robert S. (2004). "American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis". Gastroenterology. 127 (5): 1592–1622. doi:10.1053/j.gastro.2004.09.055. ISSN 0016-5085.
- ↑ Parkman HP (2015). "Idiopathic gastroparesis". Gastroenterol Clin North Am. 44 (1): 59–68. doi:10.1016/j.gtc.2014.11.015. PMC 4324534. PMID 25667023.
- ↑ Parkman, Henry P.; Yates, Katherine; Hasler, William L.; Nguyen, Linda; Pasricha, Pankaj J.; Snape, William J.; Farrugia, Gianrico; Koch, Kenneth L.; Abell, Thomas L.; McCallum, Richard W.; Lee, Linda; Unalp–Arida, Aynur; Tonascia, James; Hamilton, Frank (2011). "Clinical Features of Idiopathic Gastroparesis Vary With Sex, Body Mass, Symptom Onset, Delay in Gastric Emptying, and Gastroparesis Severity". Gastroenterology. 140 (1): 101–115.e10. doi:10.1053/j.gastro.2010.10.015. ISSN 0016-5085.
- ↑ Pasricha, Pankaj J.; Yates, Katherine P.; Nguyen, Linda; Clarke, John; Abell, Thomas L.; Farrugia, Gianrico; Hasler, William L.; Koch, Kenneth L.; Snape, William J.; McCallum, Richard W.; Sarosiek, Irene; Tonascia, James; Miriel, Laura A.; Lee, Linda; Hamilton, Frank; Parkman, Henry P. (2015). "Outcomes and Factors Associated With Reduced Symptoms in Patients With Gastroparesis". Gastroenterology. 149 (7): 1762–1774.e4. doi:10.1053/j.gastro.2015.08.008. ISSN 0016-5085.
- ↑ Koch KL, Calles-Escandón J (2015). "Diabetic gastroparesis". Gastroenterol. Clin. North Am. 44 (1): 39–57. doi:10.1016/j.gtc.2014.11.005. PMID 25667022.