Gallbladder cancer physical examination
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Overview
Patients with gallbladder cancer usually appear asymptomatic. Physical examination of patients with gallbladder cancer is usually remarkable for nonspecific symptoms that are due to cholelithiasis or cholecystitis. The preoperative diagnosis rate for gallbladder cancer was only 10 to 15 percent.
Physical Examination
- Physical examination of patients with gallbladder cancer is usually non specific or most oftenly asymptomatic.[1][2][3][4][5]
- Physical examination of patients with gallbladder cancer is usually remarkable for symptoms that are due to cholelithiasis or cholecystitis.
Appearance of the Patient
- Patients with gallbladder cancer usually appear anorexic.
Vital Signs
Skin
Abdominal Examination
- Right upper quadrant abdominal tenderness
- Courvoisier's sign: also called Courvoisier's Law is a sign of malignancy either pancreatic or of gallbladder origin rather than a sigh of cholelithiasis.[1]
- Mirizzi syndrome: when gallbladder cancer invades biliary tree or the region of the hepatoduodenal ligament, patients present with obstructive jaundice.The presence of obstructive jaundice on is highly suggestive of compression of the common hepatic duct due to impacted stone in the gallbladder neck.[6][7]
- The presence of palpable mass, ascites or paraneoplastic syndromes like acanthosis nigricans on physical examination is most likely suggestive of extra abdominal metastases.
References
- ↑ 1.0 1.1 Fitzgerald JE, White MJ, Lobo DN (2009). "Courvoisier's gallbladder: law or sign?". World J Surg. 33 (4): 886–91. doi:10.1007/s00268-008-9908-y. PMID 19190960.
- ↑ Agrawal S, Vohra S (2017). "Simultaneous Courvoisier's and double duct signs". World J Gastrointest Endosc. 9 (8): 425–427. doi:10.4253/wjge.v9.i8.425. PMC 5565509. PMID 28874964.
- ↑ Memon AA, Soomro MI, Soomro QA (2012). "Courvoisier's law revisited". J Coll Physicians Surg Pak. 22 (6): 392–4. doi:06.2012/JCPSP.392394 Check
|doi=value (help). PMID 22630101. - ↑ Gorelik O, Shteinschnaider M, Cohen N, Almoznino-Sarafian D (2013). "[Visible Courvoisier's sign: a rare presentation of bile duct obstruction]". Harefuah (in Hebrew). 152 (9): 516–7, 565. PMID 24364089.
- ↑ Munzer D (1999). "Assessment of Courvoisier's law". Saudi J Gastroenterol. 5 (3): 106–12. PMID 19864733.
- ↑ Witte CL (1984). "Choledochal obstruction by cystic duct stone. Mirizzi's syndrome". Am Surg. 50 (5): 241–3. PMID 6721287.
- ↑ Starling JR, Matallana RH (1980). "Benign mechanical obstruction of the common hepatic duct (Mirizzi syndrome)". Surgery. 88 (5): 737–40. PMID 7434217.