Pyogenic liver abscess physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Common physical examination findings associated with pyogenic liver abscess include [[Fever|high grade fever]], [[Jaundice|yellowish discoloration of skin (jaundice)]], [[icterus|icteric]] [[sclera]], reduced breath sounds or [[crepitations]] at the base of [[lung]], [[hepatomegaly]] with [[Tenderness|point tenderness]], and [[abdominal guarding]] or [[rebound tenderness]] on [[palpation]], dullness on [[percussion]], and [[absent bowel sounds]].<ref name="pmid8611070">{{cite journal| author=Chu KM, Fan ST, Lai EC, Lo CM, Wong J| title=Pyogenic liver abscess. An audit of experience over the past decade. | journal=Arch Surg | year= 1996 | volume= 131 | issue= 2 | pages= 148-52 | pmid=8611070 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8611070 }} </ref> | |||
==Physical Examination== | |||
Common physical examination findings associated with [[pyogenic liver abscess]] may include:<ref name="pmid8611070">{{cite journal| author=Chu KM, Fan ST, Lai EC, Lo CM, Wong J| title=Pyogenic liver abscess. An audit of experience over the past decade. | journal=Arch Surg | year= 1996 | volume= 131 | issue= 2 | pages= 148-52 | pmid=8611070 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8611070 }} </ref> | |||
===Appearance of Patient=== | |||
Patients with pyogenic liver abscess appear ill and sweating . Appears thin due to [[weight loss]] and confused in later stages of disease. | |||
== | ===Vital signs=== | ||
*High grade [[fever]] (>38°C) chills | |||
*[[Tachycardia]] | |||
===Skin=== | |||
[[Jaundice|Yellowish discoloration of skin (jaundice)]] | |||
===HEENT=== | |||
[[icterus|Icteric sclera]] | |||
===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 space|intercostal spaces]], or below the ribs is a typical finding. | ||
* | *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 ([[ascites]]) | |||
*[[Abdominal distension]] in advanced cases | |||
*[[Absent bowel sounds]] | |||
===Extremities=== | |||
Bilateral [[pedal edema]] in advanced [[liver]] disease | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Hepatology]] | |||
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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 pyogenic liver abscess include high grade fever, yellowish discoloration of skin (jaundice), icteric sclera, reduced breath sounds or crepitations at the base of lung, hepatomegaly with point tenderness, and abdominal guarding or rebound tenderness on palpation, dullness on percussion, and absent bowel sounds.[1]
Physical Examination
Common physical examination findings associated with pyogenic liver abscess may include:[1]
Appearance of Patient
Patients with pyogenic liver abscess appear ill and sweating . Appears thin due to weight loss and confused in later stages of disease.
Vital signs
- High grade fever (>38°C) 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.
- 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 (ascites)
- Abdominal distension in advanced cases
- Absent bowel sounds
Extremities
Bilateral pedal edema in advanced liver disease
References
- ↑ 1.0 1.1 Chu KM, Fan ST, Lai EC, Lo CM, Wong J (1996). "Pyogenic liver abscess. An audit of experience over the past decade". Arch Surg. 131 (2): 148–52. PMID 8611070.