Gastrointestinal stromal tumor physical examination

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

Overview

Common physical examination findings of gastrointestinal stromal tumors (GIST) include abdominal distension and palpable abdominal mass. Patients with severe and longstanding GIST can present with signs of abdominal perforation and signs of peritonitis such as abdominal tenderness, rigidity and guarding. Other findings include those from tumor rupture and blood loss such as low blood pressure, tachycardia, and dyspnea.

Physical Examination

• Physical examination of patients with gastrointestinal stromal tumors (GIST) is usually positive for abdominal distension and palpable abdominal mass. Other findings include:

Appearance of the Patient

• Patients with GIST usually appear tired.

Vital Signs

• Low-grade fever
• Hypothermia may be present
• Tachycardia with regular pulse
• Tachypnea
• Low blood pressure

Skin

• Jaundice (seen in obstructive duodenal GIST)
• Pallor (seen with abdominal bleeding)

HEENT

• Icteric sclera (seen in obstructive duodenal GIST)

Neck

• Lymphadenopathy (rare)

Abdomen

• Abdominal distention
• Succussion splash (gastric outlet obstruction with GIST in pylorus)
• Shifting dullness (intraperitoneal rupture of large GIST with hemoperitoneum)
• Palpable abdominal mass (location depends upon the site of GIST)
• Severe cases may have abdominal perforation with signs of peritonitis such as:
  • Abdominal tenderness
  • Rigidity
  • Guarding

Extremities

• Pitting edema of the lower extremities

References

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