Amoebic liver abscess physical examination: Difference between revisions
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'''Appearance of patient''' | '''Appearance of patient''' | ||
Patients with amoebic liver abscess are sweating and ill appearing. Appears thin due to weight loss in later stages of disease. | Patients with amoebic liver abscess are sweating and ill appearing. Appears thin due to [[weight loss]] in later stages of disease. | ||
'''Vital signs''' | '''Vital signs''' | ||
*High grade fever with chills | *High grade [[fever]] with [[chills]] | ||
*[[Tachycardia]] | *[[Tachycardia]] | ||
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*Abdominal [[guarding]] or [[rebound tenderness]] | *Abdominal [[guarding]] or [[rebound tenderness]] | ||
*Due to dullness on [[percussion]], the movement on right side of the chest and abdomen is restricted | *Due to dullness on [[percussion]], the movement on right side of the chest and abdomen is restricted | ||
*Abdominal distension in advanced cases | *[[Abdominal distension]] in advanced cases | ||
*Absent bowel sounds | *[[Absent bowel sounds]] | ||
'''Extremities''' | '''Extremities''' | ||
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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 amoebic liver abscess may include sweating and ill appearing patient with weight loss, fever with chills, tachycardia, yellowish discoloration of skin (jaundice), icteric sclera, reduced breath sounds or crepitations at right lung base may be heard, chest tenderness on palpation and audible pericardial friction rub. 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, dullness on percussion, abdominal distension and absent bowel sounds are other findings.[1][2][3]
Physical Examination
Common physical examination findings associated with amoebic liver abscess may include:[1][2][3][4][5]
Appearance of patient
Patients with amoebic liver abscess are sweating and ill appearing. Appears thin due to weight loss in later stages of disease.
Vital signs
- High grade fever with 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.[4][5]
- 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
- Abdominal distension in advanced cases
- Absent bowel sounds
Extremities
Bilateral pedal edema in advanced liver disease
References
- ↑ 1.0 1.1 https://medlineplus.gov/ency/article/000211.htm Accessed on february 8, 2017
- ↑ 2.0 2.1 Hoffner RJ, Kilaghbian T, Esekogwu VI, Henderson SO (1999). "Common presentations of amebic liver abscess". Ann Emerg Med. 34 (3): 351–5. PMID 10459092.
- ↑ 3.0 3.1 Wiwanitkit V (2002). "A note on clinical presentations of amebic liver abscess: an overview from 62 Thai patients". BMC Fam Pract. 3: 13. PMC 122079. PMID 12149132.
- ↑ 4.0 4.1 Adams EB, MacLeod IN (1977). "Invasive amebiasis. II. Amebic liver abscess and its complications". Medicine (Baltimore). 56 (4): 325–34. PMID 875719.
- ↑ 5.0 5.1 Katzenstein D, Rickerson V, Braude A (1982). "New concepts of amebic liver abscess derived from hepatic imaging, serodiagnosis, and hepatic enzymes in 67 consecutive cases in San Diego". Medicine (Baltimore). 61 (4): 237–46. PMID 6806561.