Liver mass physical examination: Difference between revisions

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Revision as of 02:19, 27 November 2017

Liver Mass Microchapters

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Evaluation of Liver Mass

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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]

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: janudice, hepatomegaly, abdominal tenderness, splenomegaly, abdominal wall vascular collaterals, and weight loss.[1]

Physical Examination

  • The following physical examination findings may be present among patients with liver mass:[1]

General appearance

Vital Signs

Chest

Inspection

  • Chest alopecia
  • Rapid rate of breathing

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
  • Described as a venous hum in patients with portal hypertension
  • Present in patients with cirrhosis

Percussion

  • Dull percussion

Palpation

Musculoskeletal

  • Peripheral edema
  • Muscle rigidity
  • Hypertrophic osteoarthropathy

Skin

Inspection

  • Muehrcke nails
  • Terry nails, or "luekonychia"

HEENT

CNS

Extremities

Gallery

References

  1. 1.0 1.1 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.


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