Linitis plastica physical examination

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

Overview

Patients with linitis plastica in the early stages may appear to be normal. When metastasis occurs, the patient usually appears fatigued and cachexic. Physical examination of patients with linitis plastica and metastasis may be remarkable for lymphadenopathy, weight loss, and signs of ascites.

Physical Examination

Physical examination of patients with metastatic linitis plastica is usually remarkable for: lymphadenopathy, ascites, and organomegaly.[1][2][2][2]

Appearance of the Patient

Patients with linitis plastica in the early stages may appear to be normal. When metastasis occurs, the patient usually appears fatigued and cachexic.

Vital Signs

Skin

Diffuse seborrheic keratoses (sign of Leser-Trélat) is shown. By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=24076793

HEENT

Neck

Lungs

  • Massive ascites leads to:
    • Decreased chest expansion
    • Fine crackles upon auscultation of the lung bases bilaterally

Abdomen

Signs of ascites:

Massive ascites is shown.By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=15335623

Genitourinary

  • A pelvic/adnexal mass may be palpated:

Extremities

  • Pitting/non-pitting edema of the upper/lower extremities
  • Irish node (left axillary node)

References

  1. Wanebo HJ, Kennedy BJ, Chmiel J, Steele G, Winchester D, Osteen R (1993). "Cancer of the stomach. A patient care study by the American College of Surgeons". Ann. Surg. 218 (5): 583–92. PMC 1243028. PMID 8239772.
  2. 2.0 2.1 2.2 Fuchs CS, Mayer RJ (1995). "Gastric carcinoma". N. Engl. J. Med. 333 (1): 32–41. doi:10.1056/NEJM199507063330107. PMID 7776992.



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