Liver mass physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
m (Bot: Removing from Primary care)
 
(23 intermediate revisions by 5 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Liver mass}}
{{Liver mass}}
{{CMG}}{{AE}}{{MV}}
{{CMG}} ; {{AE}} {{MV}} {{ADG}}


==Overview==
==Overview==
 
Physical examination findings of liver mass will depend on location and size of the tumor. Usually large liver tumors may cause [[pain]] and [[tenderness]] in [[palpation]] of the [[abdomen]] due to stretching of the [[liver]] capsule. On the other hand, liver masses with smaller size can present with no remarkable findings. Common physical examination of patients with liver mass, may include [[jaundice]], [[hepatomegaly]], abdominal [[tenderness]], [[splenomegaly]], abdominal wall vascular collaterals, and [[weight loss]].
Physical examination findings of liver mass will depend on location and size of the tumor. Usually large liver tumors may cause pain and tenderness in palpation of the abdomen due to stretching of the liver capsule. On the other hand, liver masses with smaller size can present with no remarkable findings. Common physical examination of patients with liver mass, may include: [[janudice]], [[hepatomegaly]], abdominal [[tenderness]], [[splenomegaly]], abdominal wall vascular collaterals, and [[weight loss]].


==Physical Examination==
==Physical Examination==
*The following physical examination findings may be present among patients with liver mass:
The following physical examination findings may be present among patients with liver mass:<ref name="pmid22541698">{{cite journal |vauthors=Bonder A, Afdhal N |title=Evaluation of liver lesions |journal=Clin Liver Dis |volume=16 |issue=2 |pages=271–83 |year=2012 |pmid=22541698 |doi=10.1016/j.cld.2012.03.001 |url=}}</ref><ref name="pmid15062656">{{cite journal |vauthors=Gibbs JF, Litwin AM, Kahlenberg MS |title=Contemporary management of benign liver tumors |journal=Surg. Clin. North Am. |volume=84 |issue=2 |pages=463–80 |year=2004 |pmid=15062656 |doi=10.1016/j.suc.2003.11.003 |url=}}</ref><ref name="pmid9361515">{{cite journal |vauthors=Weimann A, Ringe B, Klempnauer J, Lamesch P, Gratz KF, Prokop M, Maschek H, Tusch G, Pichlmayr R |title=Benign liver tumors: differential diagnosis and indications for surgery |journal=World J Surg |volume=21 |issue=9 |pages=983–90; discussion 990–1 |year=1997 |pmid=9361515 |doi= |url=}}</ref><ref name="pmid15815209">{{cite journal |vauthors=Choi BY, Nguyen MH |title=The diagnosis and management of benign hepatic tumors |journal=J. Clin. Gastroenterol. |volume=39 |issue=5 |pages=401–12 |year=2005 |pmid=15815209 |doi= |url=}}</ref><ref name="pmid11240457">{{cite journal |vauthors=Cherqui D |title=[Benign liver tumors] |language=French |journal=J Chir (Paris) |volume=138 |issue=1 |pages=19–26 |year=2001 |pmid=11240457 |doi= |url=}}</ref><ref name="pmid12122868">{{cite journal |vauthors=Wanless IR |title=Benign liver tumors |journal=Clin Liver Dis |volume=6 |issue=2 |pages=513–26, ix |year=2002 |pmid=12122868 |doi= |url=}}</ref><ref name="pmid7740799">{{cite journal |vauthors=Nagorney DM |title=Benign hepatic tumors: focal nodular hyperplasia and hepatocellular adenoma |journal=World J Surg |volume=19 |issue=1 |pages=13–8 |year=1995 |pmid=7740799 |doi= |url=}}</ref>


===General appearance===
===General appearance===
*Well-appearing
*Patients could be well appeared. However, some of them, based on the etiology and stage might be:
*[[Lethargic]]
**[[Lethargic]]
*[[Cachectic]]
**[[Cachexia|Cachectic]]
*Confused
**Confused


===Vital Signs===
===Vital Signs===
* High-grade or low grade [[fever]]
* [[Tachycardia]]
* [[Tachypnea]]
* Decreased SPO2
* Decreased SPO2
* [[Tachypnea]]
* [[Tachycardia]]
* [[High-grade fever]]
* [[Low-grade fever]]


===Chest===
===Chest===
'''Inspection'''
'''Inspection'''
*Chest alopecia  
*Chest [[alopecia]]
*Rapid rate of breathing
*Rapid rate of breathing
'''Auscultation'''  
'''Auscultation'''  
Line 35: Line 33:
===Abdomen===
===Abdomen===
'''Inspection'''
'''Inspection'''
*[[Hepatomegaly]]
*Caput medusae
*[[Splenomegaly]]
** Appearance of distended and engorged superficial epigastric veins
'''Auscultation'''  
'''Auscultation'''  
*''Cruveilhier-Baumgarten murmur''
*Perform the liver scratch test
:* Described as a venous hum in patients with portal hypertension
**Useful for liver size determination
:* Present in patients with cirrhosis
*Cruveilhier-Baumgarten murmur
** Described as a venous hum in patients with [[portal hypertension]]
** Present in patients with [[cirrhosis]]
'''Percussion'''
'''Percussion'''
*Dull percussion
*Dull percussion
'''Palpation'''
'''Palpation'''
*Abdominal distention
*[[Abdominal distension|Abdominal distention]]
 
*[[Tenderness]] in right upper quadrant 
*[[Hepatomegaly]]
*[[Splenomegaly]]
===Musculoskeletal===
===Musculoskeletal===
* Peripheral edema
* [[Pedal edema|Peripheral edema]]
* Muscle rigidity
* Muscle rigidity
* Hypertrophic osteoarthropathy
* [[Hypertrophic osteoarthropathy]]


===Skin===
===Skin===
Line 56: Line 58:
*[[Jaundice]]
*[[Jaundice]]
* Plantar and [[palmar erythema]]
* Plantar and [[palmar erythema]]
* Dermatographic urticaria, or "scratching marks"
* Dermatographic [[urticaria]], or "scratching marks"
* Nail changes
* Nail changes
:*Muehrcke nails  
:*Muehrcke nails  
:*Terry nails
:*Terry nails, or "[[leukonychia]]"
 
===HEENT===
===HEENT===
*[[Lymphadenopathy]]
*[[Lymphadenopathy]]


===CNS===
===CNS===
*[[Confusion]]  
*[[Confusion]]  
*[[Asterixis]]
*[[Asterixis]]
Line 74: Line 74:
*[[Weakness]]
*[[Weakness]]
* Absent [[pulse]]
* Absent [[pulse]]
==Gallery==
<div align="left">
<gallery heights="175" widths="175">
Image:PHIL 2860 lores.jpg| '''Jaundice'''
Image:|'''Portal hypertension in hepatocellular carincoma''' : This image shows the abdomen of a person with cirrhosis showing massive fluid buildup and very visible veins
</gallery>
</div>
==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
 


[[Category:Disease]]
[[Category:Medicine]]
[[Category:Types of cancer]]
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Up-To-Date]]
[[Category:Surgery]]

Latest revision as of 22:32, 29 July 2020

Liver Mass Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differential Diagnosis

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

Evaluation of Liver Mass

Staging

History and Symptoms

Physical Examination

Laboratory Studies

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Liver mass physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Liver mass physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Liver mass physical examination

CDC on Liver mass physical examination

Liver mass physical examination in the news

Blogs on Liver mass physical examination

Directions to Hospitals Treating bone or soft tissue mass

Risk calculators and risk factors for Liver mass physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2] Aditya Ganti M.B.B.S. [3]

Overview

Physical examination findings of liver mass will depend on location and size of the tumor. Usually large liver tumors may cause pain and tenderness in palpation of the abdomen due to stretching of the liver capsule. On the other hand, liver masses with smaller size can present with no remarkable findings. Common physical examination of patients with liver mass, may include jaundice, hepatomegaly, abdominal tenderness, splenomegaly, abdominal wall vascular collaterals, and weight loss.

Physical Examination

The following physical examination findings may be present among patients with liver mass:[1][2][3][4][5][6][7]

General appearance

  • Patients could be well appeared. However, some of them, based on the etiology and stage might be:

Vital Signs

Chest

Inspection

Auscultation

Percussion

  • Dull percussion
  • Reduced chest expansion

Abdomen

Inspection

  • Caput medusae
    • Appearance of distended and engorged superficial epigastric veins

Auscultation

  • Perform the liver scratch test
    • Useful for liver size determination
  • Cruveilhier-Baumgarten murmur

Percussion

  • Dull percussion

Palpation

Musculoskeletal

Skin

Inspection

HEENT

CNS

Extremities

References

  1. ↑ Bonder A, Afdhal N (2012). "Evaluation of liver lesions". Clin Liver Dis. 16 (2): 271–83. doi:10.1016/j.cld.2012.03.001. PMID 22541698.
  2. ↑ Gibbs JF, Litwin AM, Kahlenberg MS (2004). "Contemporary management of benign liver tumors". Surg. Clin. North Am. 84 (2): 463–80. doi:10.1016/j.suc.2003.11.003. PMID 15062656.
  3. ↑ Weimann A, Ringe B, Klempnauer J, Lamesch P, Gratz KF, Prokop M, Maschek H, Tusch G, Pichlmayr R (1997). "Benign liver tumors: differential diagnosis and indications for surgery". World J Surg. 21 (9): 983–90, discussion 990–1. PMID 9361515.
  4. ↑ Choi BY, Nguyen MH (2005). "The diagnosis and management of benign hepatic tumors". J. Clin. Gastroenterol. 39 (5): 401–12. PMID 15815209.
  5. ↑ Cherqui D (2001). "[Benign liver tumors]". J Chir (Paris) (in French). 138 (1): 19–26. PMID 11240457.
  6. ↑ Wanless IR (2002). "Benign liver tumors". Clin Liver Dis. 6 (2): 513–26, ix. PMID 12122868.
  7. ↑ Nagorney DM (1995). "Benign hepatic tumors: focal nodular hyperplasia and hepatocellular adenoma". World J Surg. 19 (1): 13–8. PMID 7740799.
Retrieved from "https://www.wikidoc.org/index.php?title=Liver_mass_physical_examination&oldid=1640228"