Pyloric stenosis physical examination: Difference between revisions
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=== HEENT === | === HEENT === | ||
* Icteric sclera may be present | * Icteric sclera may be present | ||
=== Neck === | === Neck === | ||
Physical examination of neck is usually normal. | |||
=== Lungs === | === Lungs === | ||
Physical examination of lungs is usually normal. | |||
=== Heart === | === Heart === | ||
* | * Physical examination of lungs is usually norma | ||
=== Abdomen === | === Abdomen === | ||
Revision as of 19:05, 4 December 2017
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Pyloric stenosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Pyloric stenosis physical examination On the Web |
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American Roentgen Ray Society Images of Pyloric stenosis physical examination |
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Risk calculators and risk factors for Pyloric stenosis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
Patients with infantile pyloric stenosis usually appear ill and toxic. physical examination of patients with infantile pyloric stenosis is usually remarkable for palpation of an abdominal mass in epigastrium.This mass, which consists of the enlarged pylorus, is referred to as the 'olive,'
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
The presence of palpation of an abdominal mass and visible peristalsis on physical examination is diagnostic of infantile pyloric stenosis.
Appearance of the Patient
Patients with infantile pyloric stenosis usually appear ill and toxic.
Vital Signs
- Hypothermia may be present
- Tachycardia with regular pulse may be present
- Tachypnea may be present
Skin
- Cyanosis may be present
- Poor skin turgur
HEENT
- Icteric sclera may be present
Neck
Physical examination of neck is usually normal.
Lungs
Physical examination of lungs is usually normal.
Heart
- Physical examination of lungs is usually norma
Abdomen
- Abdominal distention
- Abdominal tenderness in the right/left upper/lower abdominal quadrant
- Rebound tenderness (positive Blumberg sign)
- A palpable abdominal mass in the right/left upper/lower abdominal quadrant
- Guarding may be present
- Hepatomegaly / splenomegaly / hepatosplenomegaly
- Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
Back
- Point tenderness over __ vertebrae (e.g. L3-L4)
- Sacral edema
- Costovertebral angle tenderness bilaterally/unilaterally
- Buffalo hump
Genitourinary
- A pelvic/adnexal mass may be palpated
- Inflamed mucosa
- Clear/(color), foul-smelling/odorless penile/vaginal discharge
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Altered mental status
- Glasgow coma scale is ___ / 15
- Clonus may be present
- Hyperreflexia / hyporeflexia / areflexia
- Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
- Muscle rigidity
- Proximal/distal muscle weakness unilaterally/bilaterally
- ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
- Unilateral/bilateral upper/lower extremity weakness
- Unilateral/bilateral sensory loss in the upper/lower extremity
- Positive straight leg raise test
- Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
- Positive/negative Trendelenburg sign
- Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
- Normal finger-to-nose test / Dysmetria
- Absent/present dysdiadochokinesia (palm tapping test)
Extremities
- Clubbing
- Cyanosis
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity
References
Overview
Physical examination
Vital Signs
Skin
Head
Depressed fontanelles may be present
Eyes
Decereased tearing may be present
Abdomen
Palpation of the abdomen may reveal a mass in the epigastrium. This mass, which consists of the enlarged pylorus, is referred to as the 'olive,' and is sometimes evident after the infant is given formula to drink. It is an elusive diagnostic skill requiring much patience and experience. There are often palpable (or even visible) peristaltic waves due to stomach trying to force its contents past the narrowed pyloric outlet.