Autoimmune pancreatitis physical examination: Difference between revisions
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{{Autoimmune pancreatitis}} | {{Autoimmune pancreatitis}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{IQ}} | ||
==Overview== | ==Overview== | ||
Patients with [ | 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== | ==Physical Examination== | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients with [disease | Patients with [[acute]] on [[chronic]] autoimmune pancreatitis may assume a characteristic position in an attempt to relieve their [[abdominal pain]]: | ||
* Lying on the left sid | |||
* Flexing the [[spine]] | |||
* Drawing the [[knees]] up toward the chest | |||
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=== | ||
* | *Vital signs usually within normal limits | ||
===Skin=== | ===Skin=== | ||
*[[Jaundice]]<ref name="pmid18222442">{{cite journal |vauthors=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 |title=Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy |journal=Gastroenterology |volume=134 |issue=3 |pages=706–15 |year=2008 |pmid=18222442 |doi=10.1053/j.gastro.2007.12.009 |url=}}</ref><ref name="pmid17894845">{{cite journal |vauthors=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 |title=Autoimmune pancreatitis: clinical and radiological features and objective response to steroid therapy in a UK series |journal=Am. J. Gastroenterol. |volume=102 |issue=11 |pages=2417–25 |year=2007 |pmid=17894845 |doi=10.1111/j.1572-0241.2007.01531.x |url=}}</ref><ref name="pmid15459324">{{cite journal |vauthors=Sahani DV, Kalva SP, Farrell J, Maher MM, Saini S, Mueller PR, Lauwers GY, Fernandez CD, Warshaw AL, Simeone JF |title=Autoimmune pancreatitis: imaging features |journal=Radiology |volume=233 |issue=2 |pages=345–52 |year=2004 |pmid=15459324 |doi=10.1148/radiol.2332031436 |url=}}</ref><ref name="pmid19345283">{{cite journal |vauthors=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 |title=Presentation and management of post-treatment relapse in autoimmune pancreatitis/immunoglobulin G4-associated cholangitis |journal=Clin. Gastroenterol. Hepatol. |volume=7 |issue=10 |pages=1089–96 |year=2009 |pmid=19345283 |doi=10.1016/j.cgh.2009.03.021 |url=}}</ref> | |||
*[[Jaundice]] | |||
< | |||
</ | |||
=== | |||
===Neck=== | ===Neck=== | ||
*[[Jugular venous distension]] | *[[Jugular venous distension]] absent | ||
*[[Carotid bruits]] | *[[Carotid bruits]] absent | ||
*[[Lymphadenopathy]] | *[[Lymphadenopathy]] not present | ||
*[[Thyromegaly]] / thyroid nodules | *No [[Thyromegaly]] / thyroid nodules | ||
*[[Hepatojugular reflux]] | *[[Hepatojugular reflux]] absent | ||
===Lungs=== | ===Lungs=== | ||
*Vesicular breath sounds | |||
*[[Wheezing]] absent | |||
*[[Egophony]] absent | |||
*[[Bronchophony]] absent | |||
*Vesicular breath sounds | *Normal [[tactile fremitus]] | ||
*[[Wheezing]] | |||
*[[Egophony]] | |||
*[[Bronchophony]] | |||
*Normal | |||
===Heart=== | ===Heart=== | ||
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]] normal and soft | |||
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]] normal | |||
*No murmurs | |||
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]] | |||
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]] | |||
* | |||
===Abdomen=== | ===Abdomen=== | ||
*[[Abdominal tenderness]] may be noticed in the epigastrium or left upper quadrant | |||
*[[Abdominal tenderness]] in the | *A palpable abdominal mass in the epigastrium or left upper quadrant | ||
*A palpable abdominal mass in the | |||
==References== | ==References== | ||
Latest revision as of 14:22, 19 January 2018
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Autoimmune pancreatitis physical examination On the Web |
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Risk calculators and risk factors for Autoimmune pancreatitis physical examination |
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.