Gastrointestinal varices physical examination: Difference between revisions

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==Overview==
==Overview==
[[Physical examination]] of patients with gastrointestinal varices is usually remarkable for [[ascites]], [[pallor]], [[jaundice]], [[tachycardia]], low [[blood pressure]] in case of [[shock]], [[hepatomegaly]] or shrunken [[liver]] (in case of [[cirrhosis]]), [[spleenomegaly]], [[altered mental status]], [[palmar erythema]], [[cyanosis]] and [[clubbing]].


==Physical Examination==
==Physical Examination==
Physical examination of patients with gastrointestinal varices is usually remarkable for the following findings on physical examination:
[[Physical examination]] of patients with gastrointestinal varices is usually remarkable for the following findings:


===Appearance of the Patient===
===Appearance of the Patient===
*Patients with gastrointestinal varices due to chronic liver disease usually appear weak and disoriented. Patient may have pallor if there is active bleeding from varices
*Patients with gastrointestinal varices due to [[chronic liver disease]] usually appear weak and disoriented. Patient may have [[pallor]] if there is active [[bleeding]] from varices


===Vital Signs===
===Vital Signs===
*Tachycardia
*[[Tachycardia]]
*Low blood pressure in case of shock due to severe bleeding from ruptured varices
*Low [[blood pressure]] in case of [[shock]] due to severe [[bleeding]] from ruptured varices


*[[Tachycardia]] with bounding pulses
*[[Tachycardia]] with bounding pulses
*Tachypnea in case of hepatopulmonary syndrome
*[[Tachypnea]] in case of [[hepatopulmonary syndrome]]
*Low blood pressure due to blood loss in case of bleeding varices


===Skin===  
===Skin===  
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===HEENT===
===HEENT===
* Abnormalities of the head may show pallor in conjunctiva and cyanosis of the tongue, lips, and peripheries, due to low oxygen saturation
* [[Pallor]] in [[conjunctiva]] and [[cyanosis]] of the [[tongue]], [[lips]], and peripheries, due to low [[oxygen saturation]]
* Telangiectasis of the lips
* [[Telangiectasis]] of the [[lips]]


===Neck===
===Neck===
*[[Lymphadenopathy]] incase of lymphoma
*[[Lymphadenopathy]] incase of [[lymphoma]]


===Heart===
===Heart===
* S1 + S2 + 0
* S1 + S2 + 0
*Chest examination may reveal gynecomastia in males from failure of liver to metabolize estrogen (normally occurs in the liver)
*[[Chest]] examination may reveal [[gynecomastia]] in males from failure of [[liver]] to metabolize [[Estrogen-related receptor alpha|estrogen]] (normally occurs in the [[liver]])


=== Abdomen ===
=== Abdomen ===
*[[Abdominal distention]] due to ascites
*[[Abdominal distention]] due to ascites
*Dilated veins in the anterior abdominal wall
*Dilated [[veins]] in the anterior [[abdominal wall]]
*Caput medusae (tortuous paraumbilical collateral veins)
*[[Caput medusae]] ([[tortuous]] [[Paraumbilical veins|paraumbilical]] collateral veins)
*[[Hepatomegaly]] / [[splenomegaly]]
*[[Hepatomegaly]] / [[splenomegaly]]
*Paraumbilical hernia
*Paraumbilical [[hernia]]
*Liver may be shrunken in case of cirrhosis
*[[Liver]] may be shrunken in case of [[cirrhosis]]


===Genitourinary===  
===Genitourinary===  
*Testicular atrophy in males
*[[Testicular]] [[atrophy]] in [[males]]
*Rectal hemorrhoids
*[[Rectal]] [[hemorrhoids]]
*Tarry stools filling the rectal vault on rectal exam
*Tarry stools filling the [[rectal]] vault on [[Rectal examination|rectal exam]]


===Neuromuscular===
===Neuromuscular===
*Patient is will not be oriented to time, person or place in case of hepatic decompensation
*Patient is will not be oriented to time, person or place in case of [[hepatic]] [[decompensation]]
*Altered mental status
*[[Altered mental status]]
*Asterixis
*[[Asterixis]]


===Extremities===
===Extremities===
*[[Clubbing]]  
*[[Clubbing]]  
*[[Cyanosis]]  
*[[Cyanosis]]  
*Dupuytren contracture
*[[Dupuytrens contracture|Dupuytren contracture]]
*Muscle wasting
*[[Muscle wasting]]
*Palmar erythema and leukonychia
*[[Palmar erythema]] and [[leukonychia]]


==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 03:34, 13 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Physical examination of patients with gastrointestinal varices is usually remarkable for ascites, pallor, jaundice, tachycardia, low blood pressure in case of shock, hepatomegaly or shrunken liver (in case of cirrhosis), spleenomegaly, altered mental status, palmar erythema, cyanosis and clubbing.

Physical Examination

Physical examination of patients with gastrointestinal varices is usually remarkable for the following findings:

Appearance of the Patient

Vital Signs

Skin

HEENT

Neck

Heart

Abdomen

Genitourinary

Neuromuscular

Extremities

References