Alcoholic liver disease physical examination: Difference between revisions
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Revision as of 16:14, 28 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
There are certain stigmata associated with alcoholic liver disease that one should look for on physical examination. These include; jaundice, gynecomastia, spider angiomata, bruising, hepatosplenomegaly, ascites, testicular atrophy, asterixis, and palmar erythema. A thorough neurologic and mental status exam should also be done to assess for signs of hepatic encephalopathy, or other neurologic deficits that may be caused by chronic alcohol use.
Physical Examination
Vitals
- Fever may be present
Head and Neck
- Fetor hepaticus (breath smelling like a freshly opened corpse)
- Parotid hypertrophy
- Poor dentition
- Scleral icterus
Skin
- Jaundice
- Abnormal dark or light patches of skin
- Spider angiomata
- Gynecomastia
- Bruising or other indications of thrombocytopenia
- Striae
Abdomen
- Hepatosplenomegaly
- Abdominal distention
- Palpable liver edge
- Abdominal tenderness
- Ascites
- Fluid wave (due to ascites)
- Right upper quadrant tenderness
Genitourinary
Extremities
Neurologic
- Confusion, coma (encephalopathy) may be present
- Evidence of Wernicke's or Korsakoff syndrome