Autoimmune pancreatitis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]
Overview
Patients with acute on chronic autoimmune pancreatitis may assume a characteristic position in an attempt to relieve their abdominal pain. Patients with steatorrhea or advanced disease may present with loss of subcutaneous fat, temporal wasting, sunken supraclavicular fossa, and other physical signs of malnutrition.
Physical Examination
Appearance of the Patient
Patients with acute on chronic autoimmune pancreatitis may assume a characteristic position in an attempt to relieve their abdominal pain:
Patients with steatorrhea or advanced disease may present with:
- Loss of subcutaneous fat
- Temporal wasting
- Sunken supraclavicular fossa
- Other physical signs of malnutrition
Vital Signs
- Vital signs usually within normal limits
Skin
Neck
- Jugular venous distension absent
- Carotid bruits absent
- Lymphadenopathy not present
- No Thyromegaly / thyroid nodules
- Hepatojugular reflux absent
Lungs
- Vesicular breath sounds
- Wheezing absent
- Egophony absent
- Bronchophony absent
- Normal tactile fremitus
Heart
Abdomen
- Abdominal tenderness may be noticed in the epigastrium or left upper quadrant
- A palpable abdominal mass in the epigastrium or left upper quadrant
References
- ↑ Ghazale A, Chari ST, Zhang L, Smyrk TC, Takahashi N, Levy MJ, Topazian MD, Clain JE, Pearson RK, Petersen BT, Vege SS, Lindor K, Farnell MB (2008). "Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy". Gastroenterology. 134 (3): 706–15. doi:10.1053/j.gastro.2007.12.009. PMID 18222442.
- ↑ Church NI, Pereira SP, Deheragoda MG, Sandanayake N, Amin Z, Lees WR, Gillams A, Rodriguez-Justo M, Novelli M, Seward EW, Hatfield AR, Webster GJ (2007). "Autoimmune pancreatitis: clinical and radiological features and objective response to steroid therapy in a UK series". Am. J. Gastroenterol. 102 (11): 2417–25. doi:10.1111/j.1572-0241.2007.01531.x. PMID 17894845.
- ↑ Sahani DV, Kalva SP, Farrell J, Maher MM, Saini S, Mueller PR, Lauwers GY, Fernandez CD, Warshaw AL, Simeone JF (2004). "Autoimmune pancreatitis: imaging features". Radiology. 233 (2): 345–52. doi:10.1148/radiol.2332031436. PMID 15459324.
- ↑ Sandanayake NS, Church NI, Chapman MH, Johnson GJ, Dhar DK, Amin Z, Deheragoda MG, Novelli M, Winstanley A, Rodriguez-Justo M, Hatfield AR, Pereira SP, Webster GJ (2009). "Presentation and management of post-treatment relapse in autoimmune pancreatitis/immunoglobulin G4-associated cholangitis". Clin. Gastroenterol. Hepatol. 7 (10): 1089–96. doi:10.1016/j.cgh.2009.03.021. PMID 19345283.