Liver mass physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2] Aditya Ganti M.B.B.S. [3]

Overview

Physical examination findings of liver mass will depend on location and size of the tumor. Usually large liver tumors may cause pain and tenderness in palpation of the abdomen due to stretching of the liver capsule. On the other hand, liver masses with smaller size can present with no remarkable findings. Common physical examination of patients with liver mass, may include jaundice, hepatomegaly, abdominal tenderness, splenomegaly, abdominal wall vascular collaterals, and weight loss.

Physical Examination

The following physical examination findings may be present among patients with liver mass:[1][2][3][4][5][6][7]

General appearance

  • Patients could be well appeared. However, some of them, based on the etiology and stage might be:

Vital Signs

Chest

Inspection

Auscultation

Percussion

  • Dull percussion
  • Reduced chest expansion

Abdomen

Inspection

  • Caput medusae
    • Appearance of distended and engorged superficial epigastric veins

Auscultation

  • Perform the liver scratch test
    • Useful for liver size determination
  • Cruveilhier-Baumgarten murmur

Percussion

  • Dull percussion

Palpation

Musculoskeletal

Skin

Inspection

HEENT

CNS

Extremities

References

  1. Bonder A, Afdhal N (2012). "Evaluation of liver lesions". Clin Liver Dis. 16 (2): 271–83. doi:10.1016/j.cld.2012.03.001. PMID 22541698.
  2. Gibbs JF, Litwin AM, Kahlenberg MS (2004). "Contemporary management of benign liver tumors". Surg. Clin. North Am. 84 (2): 463–80. doi:10.1016/j.suc.2003.11.003. PMID 15062656.
  3. Weimann A, Ringe B, Klempnauer J, Lamesch P, Gratz KF, Prokop M, Maschek H, Tusch G, Pichlmayr R (1997). "Benign liver tumors: differential diagnosis and indications for surgery". World J Surg. 21 (9): 983–90, discussion 990–1. PMID 9361515.
  4. Choi BY, Nguyen MH (2005). "The diagnosis and management of benign hepatic tumors". J. Clin. Gastroenterol. 39 (5): 401–12. PMID 15815209.
  5. Cherqui D (2001). "[Benign liver tumors]". J Chir (Paris) (in French). 138 (1): 19–26. PMID 11240457.
  6. Wanless IR (2002). "Benign liver tumors". Clin Liver Dis. 6 (2): 513–26, ix. PMID 12122868.
  7. Nagorney DM (1995). "Benign hepatic tumors: focal nodular hyperplasia and hepatocellular adenoma". World J Surg. 19 (1): 13–8. PMID 7740799.

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