Appendix cancer physical examination

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

Overview

Patients with appendix cancer usually appear normal, pale or diaphoretic. If the patient with appendix cancer present with acute appendicitis which is quite common, abdominal tenderness, rebound tenderness, abdominal guarding, Rovsing's sign, as well as Psoas sign might be present. Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome. Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common. In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of Pellagra disease.

Physical Examination

Appearance of the Patient

  • Patients with appendix cancer usually appear normal but might be pale or diaphoretic, or even present with a facial flushing.

Vital Signs

Skin

HEENT

  • HEENT examination of patients with appendix cancer is usually normal.
  • Glossitis may be suggestive of Pellagra.

Neck

Lungs

Heart

Abdomen

Palpation

Rectal examination

Back

  • Back examination of patients with appendix cancer is usually normal.

Genitourinary

  • Genitourinary examination of patients with appendix cancer is usually normal.

Neuromuscular

Extremities

  • Extremities examination of patients with appendix cancer is usually normal.

References

  1. Chapter 5: Tumours of the Appendix - IARC. https://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb2/bb2-chap5.pdf Accessed on January 15, 2019
  2. Hardin, M. Acute Appendicitis: Review and Update. Am Fam Physician".1999, Nov 1;60(7):2027-2034
  3. Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq
  4. Hegyi J, Schwartz RA, Hegyi V (2004) Pellagra: dermatitis, dementia, and diarrhea. Int J Dermatol 43 (1):1-5. PMID: 14693013

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