Gastroparesis physical examination: Difference between revisions

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==Overview==
==Overview==
Patients with gastroparesis usually appear normal. Physical examination of patients with gastroparesis is usually remarkable for upper abdominal distension, epigastric or periumbilical tenderness, and no guarding or rigidity.
Patients with gastroparesis usually appear normal. Physical examination of patients with gastroparesis is usually remarkable for epigastric distention and tenderness.  


==Physical Examination==
==Physical Examination==
*Physical examination of patients with gastroparesis is usually remarkable for:upper abdominal distension, epigastric or periumbilical tenderness, and no guarding and rigidity.
*Physical examination of patients with gastroparesis is usually remarkable for epigastric distention and tenderness.  
*The presence of other findings on physical examination depends on cause of gastroparesis.
*The presence of other findings on physical examination depends on the various cause of gastroparesis.


===Appearance of the Patient===
===Appearance of the Patient===
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===Vital Signs===
===Vital Signs===


*Low-grade fever may be present in postviral idiopathic gastroparesis. In minority of cases, patients have a preceeding history of upper respiratory infection or gastrointestinal infection.<ref name="pmid25667023">{{cite journal| author=Parkman HP| title=Idiopathic gastroparesis. | journal=Gastroenterol Clin North Am | year= 2015 | volume= 44 | issue= 1 | pages= 59-68 | pmid=25667023 | doi=10.1016/j.gtc.2014.11.015 | pmc=4324534 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25667023  }}</ref>  
*Low-grade [[fever]] (in postviral idiopathic gastroparesis)<ref name="pmid25667023">{{cite journal| author=Parkman HP| title=Idiopathic gastroparesis. | journal=Gastroenterol Clin North Am | year= 2015 | volume= 44 | issue= 1 | pages= 59-68 | pmid=25667023 | doi=10.1016/j.gtc.2014.11.015 | pmc=4324534 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25667023  }}</ref>  
*Orthostatic hypotension may be present in diabetic gastroparesis.
*[[Orthostatic hypotension]] (in [[Diabetes mellitus|diabetic]] gastroparesis)


===Skin===
===Skin===
* Skin examination of patients with severe gastroparesis show signs of dehydration like dry mouth, dry skin , shrunken eyes.
* Dry skin (in severe [[dehydration]])
* [[Raynaud's phenomenon]] may be present in gastroparesis related to connective tissue disorder.
* [[Raynaud's phenomenon]] (in [[Connective tissue disease|connective tissue disorder]])
 
=== HEENT ===
* Dry mouth (in severe [[dehydration]])
* Shrunken eyes (in severe [[dehydration]])
 
===Neck===
===Neck===
*[[Thyromegaly]] / thyroid nodules may be present in hypothyroidism.
*Neck examination of patients with gastroparesis is usually normal.
===Lungs===
===Lungs===
*Fine/coarse [[crackles]] upon auscultation of the lung bases is a feature in connective tissue disease (eg. systemic sclerosis) related gastroparesis
*Fine/coarse [[Rales|crackles]] upon auscultation of the lung bases (in [[Connective tissue disease|connective tissue disorder]])
===Heart===
* Cardiovascular examination of patients with gastroparesis is usually normal.
 
===Abdomen===
===Abdomen===
*[[Abdominal distention]]  
*[[Abdominal distention]]  
*[[Abdominal tenderness]] in the epigastric or periumbilical region  
*[[Abdominal tenderness]] in the [[epigastric]] or periumbilical region  
*Guarding and rigidity is absent.
*Succussion splash
*succussion splash can be elicited 3 hours or more after food intake, reflecting retention of gastric content.
*[[Abdominal guarding|Guarding]] is absent.
 
=== Back ===
* Back examination of patients with gastroparesis is usually normal.
 
=== Genitourinary ===
* Genitourinary examination of patients with gastroparesis is usually normal.
 
=== Neuromuscular ===
* [[Muscles of the abdominal wall|Abdominal muscle]] wall rigidity


*
=== Extremities ===
* Extremities examination of patients with gastroparesis is usually normal.


==References==
==References==

Revision as of 17:09, 6 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]

Overview

Patients with gastroparesis usually appear normal. Physical examination of patients with gastroparesis is usually remarkable for epigastric distention and tenderness.

Physical Examination

  • Physical examination of patients with gastroparesis is usually remarkable for epigastric distention and tenderness.
  • The presence of other findings on physical examination depends on the various cause of gastroparesis.

Appearance of the Patient

  • Patients with gastroparesis usually appear normal.

Vital Signs

Skin

HEENT

Neck

  • Neck examination of patients with gastroparesis is usually normal.

Lungs

Heart

  • Cardiovascular examination of patients with gastroparesis is usually normal.

Abdomen

Back

  • Back examination of patients with gastroparesis is usually normal.

Genitourinary

  • Genitourinary examination of patients with gastroparesis is usually normal.

Neuromuscular

Extremities

  • Extremities examination of patients with gastroparesis is usually normal.

References

  1. Parkman HP (2015). "Idiopathic gastroparesis". Gastroenterol Clin North Am. 44 (1): 59–68. doi:10.1016/j.gtc.2014.11.015. PMC 4324534. PMID 25667023.

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