Portal vein thrombosis physical examination: Difference between revisions

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==Overview==
==Overview==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Patients with portal vein thrombosis usually appear ill. Common physical examination findings of portal vein thrombosis include [[abdominal pain]] or distention, [[splenomegaly]] and signs of [[ascites]].


OR
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
==Physical Examination==
==Physical Examination==
 
Physical examination of patients with portal vein thrombosis is usually remarkable for [[abdominal pain]] or distention, [[splenomegaly]] and signs of [[ascites]].
*Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
*The presence of [finding(s)] on physical examination is diagnostic of [disease name].
*The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


===Appearance of the Patient===
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].  
*Patients with portal vein thrombosis usually appear ill.<ref name="pmid20066733">{{cite journal |vauthors=Ponziani FR, Zocco MA, Campanale C, Rinninella E, Tortora A, Di Maurizio L, Bombardieri G, De Cristofaro R, De Gaetano AM, Landolfi R, Gasbarrini A |title=Portal vein thrombosis: insight into physiopathology, diagnosis, and treatment |journal=World J. Gastroenterol. |volume=16 |issue=2 |pages=143–55 |year=2010 |pmid=20066733 |pmc=2806552 |doi= |url=}}</ref><ref name="ParikhShah2010">{{cite journal|last1=Parikh|first1=Sameer|last2=Shah|first2=Riddhi|last3=Kapoor|first3=Prashant|title=Portal Vein Thrombosis|journal=The American Journal of Medicine|volume=123|issue=2|year=2010|pages=111–119|issn=00029343|doi=10.1016/j.amjmed.2009.05.023}}</ref><ref name="pmid19399912">{{cite journal |vauthors=DeLeve LD, Valla DC, Garcia-Tsao G |title=Vascular disorders of the liver |journal=Hepatology |volume=49 |issue=5 |pages=1729–64 |year=2009 |pmid=19399912 |doi=10.1002/hep.22772 |url=}}</ref><ref name="pmid19766546">{{cite journal |vauthors=Primignani M |title=Portal vein thrombosis, revisited |journal=Dig Liver Dis |volume=42 |issue=3 |pages=163–70 |year=2010 |pmid=19766546 |doi=10.1016/j.dld.2009.08.003 |url=}}</ref>


===Vital Signs===
===Vital Signs===
 
*[[Fever]]
*High-grade / low-grade fever
*[[Bradycardia]] may be present
*[[Hypothermia]] / hyperthermia may be present
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]
 
===Skin===
*[[Cyanosis]]
*[[Jaundice]]
* [[Pallor]]
* Bruises
 
<gallery widths="150px">
 
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
 
</gallery>


===HEENT===
===HEENT===
* Abnormalities of the head/hair may include ___
*Icteric [[sclera]]
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accomodation / non-reactive to neither light nor accomodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae / tragus (anterior to ear canal)
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
 
===Neck===
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]


===Abdomen===
===Abdomen===
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*[[Abdominal distention]]
*[[Abdominal distention]]
*[[Splenomegaly]]
*[[Splenomegaly]]
*[[Hepatomegaly]]
*Right upper quadrant epigastric [[tenderness]]
*Signs of [[ascites]] ([[Fluid wave test|fluid wave]])
*Signs of [[ascites]] ([[Fluid wave test|fluid wave]])
*[[Guarding]] is rare, seen in case of intra-abdominal inflammation, [[intestinal infarction]], and [[perforation]]
*[[Guarding]] is rare, seen in case of intra-abdominal inflammation, [[intestinal infarction]], and [[perforation]]
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===Neuromuscular===
===Neuromuscular===
*Patient is usually oriented to persons, place, and time
*Patient is usually oriented to persons, place, and time
* Glasgow coma scale is 15/15
* [[Glasgow coma scale]] is 15/15


===Extremities===
===Skin===
*[[Jaundice]]
*[[Palmar erythema]]
*[[Palmar erythema]]
*[[Spider angiomata]]
*[[Caput medusae]]


==References==
==References==

Latest revision as of 14:35, 29 December 2017

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

Overview

Patients with portal vein thrombosis usually appear ill. Common physical examination findings of portal vein thrombosis include abdominal pain or distention, splenomegaly and signs of ascites.

Physical Examination

Physical examination of patients with portal vein thrombosis is usually remarkable for abdominal pain or distention, splenomegaly and signs of ascites.

Appearance of the Patient

  • Patients with portal vein thrombosis usually appear ill.[1][2][3][4]

Vital Signs

HEENT

Abdomen

Neuromuscular

Skin

References

  1. ↑ Ponziani FR, Zocco MA, Campanale C, Rinninella E, Tortora A, Di Maurizio L, Bombardieri G, De Cristofaro R, De Gaetano AM, Landolfi R, Gasbarrini A (2010). "Portal vein thrombosis: insight into physiopathology, diagnosis, and treatment". World J. Gastroenterol. 16 (2): 143–55. PMC 2806552. PMID 20066733.
  2. ↑ Parikh, Sameer; Shah, Riddhi; Kapoor, Prashant (2010). "Portal Vein Thrombosis". The American Journal of Medicine. 123 (2): 111–119. doi:10.1016/j.amjmed.2009.05.023. ISSN 0002-9343.
  3. ↑ DeLeve LD, Valla DC, Garcia-Tsao G (2009). "Vascular disorders of the liver". Hepatology. 49 (5): 1729–64. doi:10.1002/hep.22772. PMID 19399912.
  4. ↑ Primignani M (2010). "Portal vein thrombosis, revisited". Dig Liver Dis. 42 (3): 163–70. doi:10.1016/j.dld.2009.08.003. PMID 19766546.

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