Peutz-Jeghers syndrome physical examination: Difference between revisions

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__NOTOC__
__NOTOC__
{{Peutz-Jeghers syndrome}}
{{Peutz-Jeghers syndrome}}
{{CMG}} {{AE}} {{MJK}}
{{CMG}}; {{AE}} {{HQ}}
==Overview==
==Overview==
Common physical examination findings of Peutz-Jeghers syndrome include [[mucocutaneous]] [[hyperpigmentation]], [[abdominal tenderness]] due to [[intussusception]], [[bowel obstruction]], and [[pallor]] due to [[anemia]].
Common physical examination findings of Peutz-Jeghers syndrome include [[mucocutaneous]] [[hyperpigmentation]], [[abdominal tenderness]] due to [[intussusception]], [[bowel obstruction]], and [[pallor]] due to [[anemia]].


==Physical Examination==
==Physical Examination==
The physical exam findings are as follows:<ref name="KopacovaTacheci2009">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref><ref name="pmid25460448">{{cite journal| author=Hofmann S, Barth TF, Kornmann M, Henne-Bruns D| title=Appendix carcinoid associated with the Peutz-Jeghers syndrome. | journal=Int J Surg Case Rep | year= 2014 | volume= 5 | issue= 12 | pages= 964-7 | pmid=25460448 | doi=10.1016/j.ijscr.2014.06.024 | pmc=PMC4276270 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25460448  }} </ref>
===Appearance of the Patient===
===Appearance of the Patient===
*[[Cachexia]] may be suggestive of [[cancer]]
*[[Cachexia]] may be suggestive of [[cancer]].


{| align="right"
|
[[File:Peutz-Jeghers Syndrome Hyperpigmentation.jpg|none|thumb|400x400px|Hyperpigmentation - [https://upload.wikimedia.org/wikipedia/commons/9/93/Peutz-Jeghers-Syndrom.JPG Source: By Abdullah Sarhan (Own work), Wikimedia Commons]]]
|}
===Vitals===
===Vitals===
   
   
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===Throat===
===Throat===
*Oral mucosa
*[[Oral mucosa]]
:*[[Mucocutaneous]] [[pigmentation]] causing patches of hyperpigmentation in the oral mucosa ([[gingiva]], [[hard palate]], [[buccal mucosa]], and labial mucosa)<ref name="pmid25460448">{{cite journal| author=Hofmann S, Barth TF, Kornmann M, Henne-Bruns D| title=Appendix carcinoid associated with the Peutz-Jeghers syndrome. | journal=Int J Surg Case Rep | year= 2014 | volume= 5 | issue= 12 | pages= 964-7 | pmid=25460448 | doi=10.1016/j.ijscr.2014.06.024 | pmc=PMC4276270 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25460448  }} </ref>
:*[[Mucocutaneous]] [[pigmentation]] causing patches of [[hyperpigmentation]] in the [[oral mucosa]] ([[gingiva]], [[hard palate]], [[buccal mucosa]], and [[labial]] [[mucosa]])


===Neck===
===Neck===
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*If [[lung cancer]] develops, the patient may present with the following:
*If [[lung cancer]] develops, the patient may present with the following:
:*[[Wheezing]]  
:*[[Wheezing]]  
:*Consolidation with reduced breath sounds on [[auscultation]]
:*Consolidation with reduced [[breath sounds]] on [[auscultation]]
:*[[Rales]]
:*[[Rales]]
:*[[Egophony]]
:*[[Egophony]]
Line 42: Line 48:
*[[Rebound tenderness]]
*[[Rebound tenderness]]
*An [[acute abdomen]] may be suggestive of [[intussusception]]
*An [[acute abdomen]] may be suggestive of [[intussusception]]
*An abdominal mass may be suggestive of [[hepatic]] or [[pancreatic]] cancer
*An abdominal mass may be suggestive of [[Hepatic cancer|hepatic]] or [[pancreatic cancer]]
*Guarding
*[[Abdominal guarding|Guarding]]
*[[Hepatomegaly]] may be suggestive of [[hepatic cancer]]
*[[Hepatomegaly]] may be suggestive of [[hepatic cancer]]


===Extremities===
===Extremities===
*Patches of [[hyperpigmentation]] on the hands and feet<ref name="pmid25460448">{{cite journal| author=Hofmann S, Barth TF, Kornmann M, Henne-Bruns D| title=Appendix carcinoid associated with the Peutz-Jeghers syndrome. | journal=Int J Surg Case Rep | year= 2014 | volume= 5 | issue= 12 | pages= 964-7 | pmid=25460448 | doi=10.1016/j.ijscr.2014.06.024 | pmc=PMC4276270 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25460448  }} </ref>
*Patches of [[hyperpigmentation]] on the hands and feet
*[[Clubbing]] may be suggestive of lung cancer
*[[Clubbing]] may be suggestive of [[lung cancer]]
*[[Cyanosis]] may be suggestive of lung cancer
*[[Cyanosis]] may be suggestive of [[lung cancer]]
===Gallery==
 
[[File:PJS22.jpg|thumb|none|300px| Perioral and perinasal  hyperpigmentations]]
[[File:PJS44.jpg|thumb|none|300px| Hyperpigmentations on the finger tips.]]


== References ==
== References ==
{{reflist|2}}
{{reflist|2}}


{{Phakomatoses}}
{{Digestive system neoplasia}}
[[Category:Dental disorders]]
[[Category:Gastroenterology]]
[[Category:Genetic disorders]]
[[Category:Syndromes]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Oncology]]
[[Category:Disease]]
[[Category:Pediatrics]]
[[Category:Up-To-Date]]

Latest revision as of 14:57, 21 December 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

Common physical examination findings of Peutz-Jeghers syndrome include mucocutaneous hyperpigmentation, abdominal tenderness due to intussusception, bowel obstruction, and pallor due to anemia.

Physical Examination

The physical exam findings are as follows:[1][2]

Appearance of the Patient

Hyperpigmentation - Source: By Abdullah Sarhan (Own work), Wikimedia Commons

Vitals

Skin

Eyes

Throat

Neck

Lungs

  • If lung cancer develops, the patient may present with the following:

Abdomen

Extremities

References

  1. Kopacova, Marcela; Tacheci, Ilja; Rejchrt, Stanislav; Bures, Jan (2009). "Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach". World Journal of Gastroenterology. 15 (43): 5397. doi:10.3748/wjg.15.5397. ISSN 1007-9327.
  2. Hofmann S, Barth TF, Kornmann M, Henne-Bruns D (2014). "Appendix carcinoid associated with the Peutz-Jeghers syndrome". Int J Surg Case Rep. 5 (12): 964–7. doi:10.1016/j.ijscr.2014.06.024. PMC 4276270. PMID 25460448.

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