Amoebic liver abscess physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Common physical examination findings associated with [[amoebic liver abscess]] may include sweating and ill appearing patient with [[weight loss]], [[fever]] with [[chills]], [[tachycardia]], [[jaundice|yellowish discoloration of skin (jaundice)]], [[Icterus|icteric sclera]], reduced breath sounds or [[crepitations]] at right lung base may be heard, [[chest]] [[tenderness]] on [[palpation]] and audible [[pericardial friction rub]]. [[Hepatomegaly]] with point tenderness over the [[liver]], in the [[intercostal spaces]], or below the [[rib]]s is a typical finding [[Epigastric]] mass if left lobe is involved. [[Abdominal guarding]] or [[rebound tenderness]], dullness on [[percussion]], [[abdominal distension]] and [[absent bowel sounds]] are other findings.<ref name=amoebiasis>https://medlineplus.gov/ency/article/000211.htm Accessed on february 8, 2017</ref><ref name="pmid10459092">{{cite journal| author=Hoffner RJ, Kilaghbian T, Esekogwu VI, Henderson SO| title=Common presentations of amebic liver abscess. | journal=Ann Emerg Med | year= 1999 | volume= 34 | issue= 3 | pages= 351-5 | pmid=10459092 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10459092 }} </ref><ref name="pmid12149132">{{cite journal| author=Wiwanitkit V| title=A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients. | journal=BMC Fam Pract | year= 2002 | volume= 3 | issue= | pages= 13 | pmid=12149132 | doi= | pmc=122079 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12149132 }} </ref> | |||
==Physical Examination== | ==Physical Examination== | ||
Common physical examination findings associated with amoebic liver abscess may include:<ref name=amoebiasis>https://medlineplus.gov/ency/article/000211.htm Accessed on february 8, 2017</ref> | Common physical examination findings associated with [[amoebic liver abscess]] may include:<ref name=amoebiasis>https://medlineplus.gov/ency/article/000211.htm Accessed on february 8, 2017</ref><ref name="pmid10459092">{{cite journal| author=Hoffner RJ, Kilaghbian T, Esekogwu VI, Henderson SO| title=Common presentations of amebic liver abscess. | journal=Ann Emerg Med | year= 1999 | volume= 34 | issue= 3 | pages= 351-5 | pmid=10459092 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10459092 }} </ref><ref name="pmid12149132">{{cite journal| author=Wiwanitkit V| title=A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients. | journal=BMC Fam Pract | year= 2002 | volume= 3 | issue= | pages= 13 | pmid=12149132 | doi= | pmc=122079 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12149132 }} </ref><ref name="pmid875719">{{cite journal| author=Adams EB, MacLeod IN| title=Invasive amebiasis. II. Amebic liver abscess and its complications. | journal=Medicine (Baltimore) | year= 1977 | volume= 56 | issue= 4 | pages= 325-34 | pmid=875719 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=875719 }} </ref><ref name="pmid6806561">{{cite journal| author=Katzenstein D, Rickerson V, Braude A| title=New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego. | journal=Medicine (Baltimore) | year= 1982 | volume= 61 | issue= 4 | pages= 237-46 | pmid=6806561 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6806561 }} </ref> | ||
'''Appearance of patient''' | '''Appearance of patient''' | ||
Patients with amoebic liver abscess are sweating and ill appearing. Appears thin due to weight loss in later stages of disease. | Patients with amoebic liver abscess are sweating and ill appearing. Appears thin due to [[weight loss]] in later stages of disease. | ||
'''Vital signs''' | '''Vital signs''' | ||
*High grade fever with chills | *High grade [[fever]] with [[chills]] | ||
*Tachycardia | *[[Tachycardia]] | ||
'''Skin''' | '''Skin''' | ||
Yellowish discoloration of skin (jaundice) | [[jaundice|Yellowish discoloration of skin (jaundice)]] | ||
'''HEENT''' | '''HEENT''' | ||
Icteric sclera | [[icterus|Icteric sclera]] | ||
'''Lungs''' | '''Lungs''' | ||
Reduced breath sounds or crepitations at right lung base may be heard | Reduced breath sounds or [[crepitations]] at right lung base may be heard | ||
'''Heart''' | '''Heart''' | ||
*Chest tenderness on palpation | *[[Chest]] [[tenderness]] on [[palpation]] | ||
*Audible pericardial friction rub (sign associated with high mortality) | *Audible [[pericardial friction rub]] (sign associated with [[Mortality|high mortality]]) | ||
*S1 and S2 are normal | *S1 and S2 are normal | ||
'''Abdomen''' | '''Abdomen''' | ||
*Hepatomegaly with point tenderness over the liver, in the intercostal spaces, or below the ribs is a typical finding.<ref name="pmid875719">{{cite journal| author=Adams EB, MacLeod IN| title=Invasive amebiasis. II. Amebic liver abscess and its complications. | journal=Medicine (Baltimore) | year= 1977 | volume= 56 | issue= 4 | pages= 325-34 | pmid=875719 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=875719 }} </ref><ref name="pmid6806561">{{cite journal| author=Katzenstein D, Rickerson V, Braude A| title=New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego. | journal=Medicine (Baltimore) | year= 1982 | volume= 61 | issue= 4 | pages= 237-46 | pmid=6806561 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6806561 }} </ref> | *[[Hepatomegaly]] with point tenderness over the [[liver]], in the [[intercostal spaces]], or below the ribs is a typical finding.<ref name="pmid875719">{{cite journal| author=Adams EB, MacLeod IN| title=Invasive amebiasis. II. Amebic liver abscess and its complications. | journal=Medicine (Baltimore) | year= 1977 | volume= 56 | issue= 4 | pages= 325-34 | pmid=875719 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=875719 }} </ref><ref name="pmid6806561">{{cite journal| author=Katzenstein D, Rickerson V, Braude A| title=New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego. | journal=Medicine (Baltimore) | year= 1982 | volume= 61 | issue= 4 | pages= 237-46 | pmid=6806561 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6806561 }} </ref> | ||
*Epigastric mass if left lobe is involved | *[[Epigastric]] mass if left lobe is involved | ||
*Abdominal guarding or rebound tenderness | *Abdominal [[guarding]] or [[rebound tenderness]] | ||
*Abdominal distension in advanced cases | *Due to dullness on [[percussion]], the movement on right side of the chest and abdomen is restricted | ||
* | *[[Abdominal distension]] in advanced cases | ||
*[[Absent bowel sounds]] | |||
'''Extremities''' | |||
Bilateral [[pedal edema]] in advanced liver disease | |||
Bilateral pedal edema in advanced liver disease | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Surgery]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Infectious disease]] | |||
[[Category:Hepatology]] | |||
Latest revision as of 20:23, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Common physical examination findings associated with amoebic liver abscess may include sweating and ill appearing patient with weight loss, fever with chills, tachycardia, yellowish discoloration of skin (jaundice), icteric sclera, reduced breath sounds or crepitations at right lung base may be heard, chest tenderness on palpation and audible pericardial friction rub. Hepatomegaly with point tenderness over the liver, in the intercostal spaces, or below the ribs is a typical finding Epigastric mass if left lobe is involved. Abdominal guarding or rebound tenderness, dullness on percussion, abdominal distension and absent bowel sounds are other findings.[1][2][3]
Physical Examination
Common physical examination findings associated with amoebic liver abscess may include:[1][2][3][4][5]
Appearance of patient
Patients with amoebic liver abscess are sweating and ill appearing. Appears thin due to weight loss in later stages of disease.
Vital signs
- High grade fever with chills
- Tachycardia
Skin
Yellowish discoloration of skin (jaundice)
HEENT
Lungs
Reduced breath sounds or crepitations at right lung base may be heard
Heart
- Chest tenderness on palpation
- Audible pericardial friction rub (sign associated with high mortality)
- S1 and S2 are normal
Abdomen
- Hepatomegaly with point tenderness over the liver, in the intercostal spaces, or below the ribs is a typical finding.[4][5]
- Epigastric mass if left lobe is involved
- Abdominal guarding or rebound tenderness
- Due to dullness on percussion, the movement on right side of the chest and abdomen is restricted
- Abdominal distension in advanced cases
- Absent bowel sounds
Extremities
Bilateral pedal edema in advanced liver disease
References
- ↑ 1.0 1.1 https://medlineplus.gov/ency/article/000211.htm Accessed on february 8, 2017
- ↑ 2.0 2.1 Hoffner RJ, Kilaghbian T, Esekogwu VI, Henderson SO (1999). "Common presentations of amebic liver abscess". Ann Emerg Med. 34 (3): 351–5. PMID 10459092.
- ↑ 3.0 3.1 Wiwanitkit V (2002). "A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients". BMC Fam Pract. 3: 13. PMC 122079. PMID 12149132.
- ↑ 4.0 4.1 Adams EB, MacLeod IN (1977). "Invasive amebiasis. II. Amebic liver abscess and its complications". Medicine (Baltimore). 56 (4): 325–34. PMID 875719.
- ↑ 5.0 5.1 Katzenstein D, Rickerson V, Braude A (1982). "New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego". Medicine (Baltimore). 61 (4): 237–46. PMID 6806561.