Gallbladder cancer physical examination: Difference between revisions
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** '''[[Courvoisier's sign]]''': Also called [[Courvoisier's law|Courvoisier's]] Law is a sigh of malignancy either pancreatic or of gallbladder orgin rather than a sigh of cholelithiasis.<ref name="pmid19190960">{{cite journal |vauthors=Fitzgerald JE, White MJ, Lobo DN |title=Courvoisier's gallbladder: law or sign? |journal=World J Surg |volume=33 |issue=4 |pages=886–91 |year=2009 |pmid=19190960 |doi=10.1007/s00268-008-9908-y |url=}}</ref> <ref name="pmid28874964">{{cite journal |vauthors=Agrawal S, Vohra S |title=Simultaneous Courvoisier's and double duct signs |journal=World J Gastrointest Endosc |volume=9 |issue=8 |pages=425–427 |year=2017 |pmid=28874964 |pmc=5565509 |doi=10.4253/wjge.v9.i8.425 |url=}}</ref><ref name="pmid22630101">{{cite journal |vauthors=Memon AA, Soomro MI, Soomro QA |title=Courvoisier's law revisited |journal=J Coll Physicians Surg Pak |volume=22 |issue=6 |pages=392–4 |year=2012 |pmid=22630101 |doi=06.2012/JCPSP.392394 |url=}}</ref><ref name="pmid24364089">{{cite journal |vauthors=Gorelik O, Shteinschnaider M, Cohen N, Almoznino-Sarafian D |title=[Visible Courvoisier's sign: a rare presentation of bile duct obstruction] |language=Hebrew |journal=Harefuah |volume=152 |issue=9 |pages=516–7, 565 |year=2013 |pmid=24364089 |doi= |url=}}</ref><ref name="pmid19864733">{{cite journal |vauthors=Munzer D |title=Assessment of Courvoisier's law |journal=Saudi J Gastroenterol |volume=5 |issue=3 |pages=106–12 |year=1999 |pmid=19864733 |doi= |url=}}</ref> | ** '''[[Courvoisier's sign]]''': Also called [[Courvoisier's law|Courvoisier's]] Law is a sigh of malignancy either pancreatic or of gallbladder orgin rather than a sigh of cholelithiasis.<ref name="pmid19190960">{{cite journal |vauthors=Fitzgerald JE, White MJ, Lobo DN |title=Courvoisier's gallbladder: law or sign? |journal=World J Surg |volume=33 |issue=4 |pages=886–91 |year=2009 |pmid=19190960 |doi=10.1007/s00268-008-9908-y |url=}}</ref> <ref name="pmid28874964">{{cite journal |vauthors=Agrawal S, Vohra S |title=Simultaneous Courvoisier's and double duct signs |journal=World J Gastrointest Endosc |volume=9 |issue=8 |pages=425–427 |year=2017 |pmid=28874964 |pmc=5565509 |doi=10.4253/wjge.v9.i8.425 |url=}}</ref><ref name="pmid22630101">{{cite journal |vauthors=Memon AA, Soomro MI, Soomro QA |title=Courvoisier's law revisited |journal=J Coll Physicians Surg Pak |volume=22 |issue=6 |pages=392–4 |year=2012 |pmid=22630101 |doi=06.2012/JCPSP.392394 |url=}}</ref><ref name="pmid24364089">{{cite journal |vauthors=Gorelik O, Shteinschnaider M, Cohen N, Almoznino-Sarafian D |title=[Visible Courvoisier's sign: a rare presentation of bile duct obstruction] |language=Hebrew |journal=Harefuah |volume=152 |issue=9 |pages=516–7, 565 |year=2013 |pmid=24364089 |doi= |url=}}</ref><ref name="pmid19864733">{{cite journal |vauthors=Munzer D |title=Assessment of Courvoisier's law |journal=Saudi J Gastroenterol |volume=5 |issue=3 |pages=106–12 |year=1999 |pmid=19864733 |doi= |url=}}</ref> | ||
* The presence of palpable mass, ascites or paraneoplastic syndromes like acanthosis nigricans on physical examination is most likely suggestive of extraabdominal metastases. | * The presence of palpable mass, [[ascites]] or [[Paraneoplastic syndrome|paraneoplastic]] syndromes like [[acanthosis nigricans]] on physical examination is most likely suggestive of extraabdominal [[Metastasis|metastases]]. | ||
* Patient who are not asymptomatic they come with pain followed by anorexia, nausea, or vomiting. | * Patient who are not asymptomatic they come with pain followed by anorexia, nausea, or vomiting. | ||
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== Vital Signs == | == Vital Signs == | ||
* '''Courvoisier's sign''': Also called Courvoisier's Law is a sigh of malignancy either pancreatic or of gallbladder orgin rather than a sigh of cholelithiasis.<ref name="pmid19190960" /> | * '''[[Courvoisier's sign]]''': Also called Courvoisier's Law is a sigh of malignancy either pancreatic or of gallbladder orgin rather than a sigh of cholelithiasis.<ref name="pmid19190960" /> | ||
* '''Mirizzi syndrome''': when gallbladder cancer invades biliary tree or the region of the hepatoduodenal ligament, Patients present with | * '''[[Mirizzi's syndrome|Mirizzi syndrome]]''': when gallbladder cancer invades biliary tree or the region of the [[Hepatoduodenal ligament|hepatoduodenal]] ligament, Patients present with obstructive jaundice .The presence of obsetrive jaundice on is highly suggestive of compression of the common hepatic duct due to impacted stone in the gallbladder neck.<ref name="pmid6721287">{{cite journal |vauthors=Witte CL |title=Choledochal obstruction by cystic duct stone. Mirizzi's syndrome |journal=Am Surg |volume=50 |issue=5 |pages=241–3 |year=1984 |pmid=6721287 |doi= |url=}}</ref><ref name="pmid7434217">{{cite journal |vauthors=Starling JR, Matallana RH |title=Benign mechanical obstruction of the common hepatic duct (Mirizzi syndrome) |journal=Surgery |volume=88 |issue=5 |pages=737–40 |year=1980 |pmid=7434217 |doi= |url=}}</ref> | ||
Revision as of 16:02, 1 February 2018
Overview
Patients with gallbladder cancer usually appear asymptomatic. Physical examination of patients with gallbladder cancer is usually remarkable for nonspecific symptoms that are due to cholelithiasis or cholecystitis.The preoperative diagnosis rate for gallbladder cancer was only 10 to 15 percent
Physical Examination
- Physical examination of patients with gallbladder cancer is usually non specific or most oftenly asymptomatic.
- Physical examination of patients with gallbladder cancer is usually remarkable for symptoms that are due to cholelithiasis or cholecystitis.
- .The presence of palpable gallbladder on physical examination is highly suggestive of gallbladder cancer.
- Courvoisier's sign: Also called Courvoisier's Law is a sigh of malignancy either pancreatic or of gallbladder orgin rather than a sigh of cholelithiasis.[1] [2][3][4][5]
- The presence of palpable mass, ascites or paraneoplastic syndromes like acanthosis nigricans on physical examination is most likely suggestive of extraabdominal metastases.
- Patient who are not asymptomatic they come with pain followed by anorexia, nausea, or vomiting.
Appearance of the Patient
- Patients with gallbladder cancer usually appear anorexic.
Vital Signs
- Courvoisier's sign: Also called Courvoisier's Law is a sigh of malignancy either pancreatic or of gallbladder orgin rather than a sigh of cholelithiasis.[1]
- Mirizzi syndrome: when gallbladder cancer invades biliary tree or the region of the hepatoduodenal ligament, Patients present with obstructive jaundice .The presence of obsetrive jaundice on is highly suggestive of compression of the common hepatic duct due to impacted stone in the gallbladder neck.[6][7]
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References
- ↑ 1.0 1.1 Fitzgerald JE, White MJ, Lobo DN (2009). "Courvoisier's gallbladder: law or sign?". World J Surg. 33 (4): 886–91. doi:10.1007/s00268-008-9908-y. PMID 19190960.
- ↑ Agrawal S, Vohra S (2017). "Simultaneous Courvoisier's and double duct signs". World J Gastrointest Endosc. 9 (8): 425–427. doi:10.4253/wjge.v9.i8.425. PMC 5565509. PMID 28874964.
- ↑ Memon AA, Soomro MI, Soomro QA (2012). "Courvoisier's law revisited". J Coll Physicians Surg Pak. 22 (6): 392–4. doi:06.2012/JCPSP.392394 Check
|doi=value (help). PMID 22630101. - ↑ Gorelik O, Shteinschnaider M, Cohen N, Almoznino-Sarafian D (2013). "[Visible Courvoisier's sign: a rare presentation of bile duct obstruction]". Harefuah (in Hebrew). 152 (9): 516–7, 565. PMID 24364089.
- ↑ Munzer D (1999). "Assessment of Courvoisier's law". Saudi J Gastroenterol. 5 (3): 106–12. PMID 19864733.
- ↑ Witte CL (1984). "Choledochal obstruction by cystic duct stone. Mirizzi's syndrome". Am Surg. 50 (5): 241–3. PMID 6721287.
- ↑ Starling JR, Matallana RH (1980). "Benign mechanical obstruction of the common hepatic duct (Mirizzi syndrome)". Surgery. 88 (5): 737–40. PMID 7434217.