Linitis plastica physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]

Overview

Common physical examination findings of linitis plastica may include lymphadenopathy, organomegaly and signs of ascites.

Physical examination

Physical examination in patients with early stages may be normal. In metastatic disease, the following may be noticed:

• Lymphadenopathy
  • Lymphatic spread of the disease may result in swelling of various groups of lymph nodes.
    • Virchow's node (left supraclavicular lymph node)
    • Sister Mary Joseph nodule (palpable nodule bulging into the umbilicus)
• Organomegaly
  • Liver may be enlarged from metastasis and palpable.
• Ascites may be the presenting symptom as well in patients with peritoneal metastasis.
  • Flank fullness
  • Shifting dullness (difference in percussion note in the flanks that shifts when the patient is turned on the side)
  • If the ascites is massive, a fluid thrill or fluid wave is present (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen).

References

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