Pyogenic liver abscess physical examination

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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]

Physical Examination

Common physical examination findings associated with pyogenic liver abscess may include:

Appearance of Patient

Patients with pyogenic liver abscess are sweating and ill appearing. Appears thin due to weight loss in later stages of disease.

Vital signs

• High grade fever (>38°C) chills
• Tachycardia

Skin

Yellowish discoloration of skin (jaundice)

HEENT

Icteric sclera

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 (ascites)
• Abdominal distension in advanced cases
• Absent bowel sounds