Appendix cancer physical examination

Appendix cancer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Epidemiology and Demographics
Differentiating Appendix cancer from other Diseases
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
MRI
CT scan
Echocardiography and Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Appendix cancer physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Appendix cancer 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 Appendix cancer physical examination
CDC on Appendix cancer physical examination
Appendix cancer physical examination in the news
Blogs on Appendix cancer physical examination
Directions to Hospitals Treating Appendix cancer
Risk calculators and risk factors for Appendix cancer physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

Patients with appendix cancer usually appear normal, pale or diaphoretic. If the patient with appendix cancer present with acute appendicitis which is quit common, abdominal tenderness, Rebound tenderness, abdominal guarding, Rovsing's sign, as well as Psoas sign might be present. Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome. Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common. In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of of Pellagra disease.

Physical Examination

• Physical examination of patients with appendix cancer is usually normal.
• If the patient with appendix cancer present with acute appendicitis which is quit common, abdominal tenderness, Rebound tenderness, abdominal guarding, Rovsing's sign, as well as Psoas sign might be present.
• Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome.
• Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common.
• In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of of Pellagra disease.

Appearance of the Patient

• Patients with appendix cancer usually appear normal but might be pale or diaphoretic, or even present with a facial flushing.

Vital Signs

• Fever might be present in patients presenting with appendicitis.
• Tachycardia is prevalent in patients with carcinoid syndrome as well as patients with appendicitis.
• Tachypnea
• Hypertension

Skin

• Skin examination of patients with appendix cancer is usually normal.

in the presence of carcinoid syndrome the following might be present:

• Flushing
• Hirsutism
• Pallor

HEENT

• HEENT examination of patients with appendix cancer is usually normal.

Neck

• Neck examination of patients with appendiceal cancer is usually normal.
• Cervical lymphadenopathy might be present.

Lungs

• Pulmonary examination of patients with appendix cancer is usually normal.
• Wheezing : if the patient develop carcinoid syndrome

Heart

• Cardiovascular examination of patients with appendix cancer is usually normal.

but

• if the patient develop carcinoid syndrome systolic or diastolic murmur might be present
• Right heart murmurs specially TR is prevalent.

Abdomen

• Abdominal examination of patients with [disease name] is usually normal.

OR

• Abdominal distension
• Abdominal tenderness in the right/left upper/lower abdominal quadrant
• Rebound tenderness (positive Blumberg sign)
• A palpable abdominal mass in the right/left upper/lower abdominal quadrant
• Guarding may be present
• Hepatomegaly / splenomegaly / hepatosplenomegaly
• Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
• Abdominal examination may be remarkable for:

Palpation

• The abdominal wall is very sensitive to mild palpation
• Rebound tenderness
• Abdominal guarding
• Rovsing's sign
• Psoas sign

Rectal examination

• Tenderness in the rectovesical pouch

Back

• Back examination of patients with [disease name] is usually normal.

OR

• Point tenderness over __ vertebrae (e.g. L3-L4)
• Sacral edema
• Costovertebral angle tenderness bilaterally/unilaterally
• Buffalo hump

Genitourinary

• Genitourinary examination of patients with [disease name] is usually normal.

OR

• A pelvic/adnexal mass may be palpated
• Inflamed mucosa
• Clear/(color), foul-smelling/odorless penile/vaginal discharge

Neuromuscular

• Neuromuscular examination of patients with [disease name] is usually normal.

OR

• Patient is usually oriented to persons, place, and time
• Altered mental status
• Glasgow coma scale is ___ / 15
• Clonus may be present
• Hyperreflexia / hyporeflexia / areflexia
• Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
• Muscle rigidity
• Proximal/distal muscle weakness unilaterally/bilaterally
• ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
• Unilateral/bilateral upper/lower extremity weakness
• Unilateral/bilateral sensory loss in the upper/lower extremity
• Positive straight leg raise test
• Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
• Positive/negative Trendelenburg sign
• Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
• Normal finger-to-nose test / Dysmetria
• Absent/present dysdiadochokinesia (palm tapping test)

Extremities

• Extremities examination of patients with appendix cancer is usually normal.

• rarely patients with carcionid syndrome might present with lower limb edema