Peutz-Jeghers syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

Common physical examination findings of Peutz-Jeghers syndrome include mucocutaneous hyperpigmentation, abdominal tenderness due to intussusception, bowel obstruction, and pallor due to anemia.

Physical Examination

Appearance of the Patient

• If cancer develops, patient may appear cachectic

Vitals

Temperature

• Fever may be present, if cancer develops

Respiratory Rate

• Tachypnea may be present, if lung cancer develops

Skin

• Jaundice may be present, if pancreatic cancer develops

Eyes

• Icteric sclera may be present

Throat

• Oral mucosa

• Mucocutaneous pigmentation causing patches of hyperpigmentation in the oral mucosa (gingiva, hard palate, buccal mucosa, and labial mucosa)

Perioral and perinasal hyperpigmentations

Neck

• Lymph nodes may be present, if cancer develops

Lungs

• If lung cancer develops, the patient may present with the following:

• Pulmonary edema and rales may be present
• Wheezing may be present
• Consolidation may be present with reduced breath sounds on auscultation
• Rales may be present
• Egophony may be present
• Chest movement may be asymmetric

Abdomen

• Abdominal distention may be present
• Abdominal tenderness may be present
• Rebound tenderness may be present
• An acute abdomen may be present, if intussusception develops
• An abdominal mass may be present, if hepatic or pancreatic cancers develop
• Guarding may be present
• Hepatomegaly may be present, if hepatic cancer develops

Extremities

• Patches of hyperpigmentation on the hands and feet
• Clubbing may be present, if lung cancer develops
• Cyanosis may be present, if lung cancer develops

Hyperpigmentations on the finger tips

References

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