Medically Fit For Exams
Medically Fit For Exams

Gastrointestinal examination abnormalities

Anaemia

  • General pallor
  • Koilonychia
  • Pale palmar creases
  • Tachycardia
  • Conjunctival pallor
  • Glossitis
  • Angular stomatitis

 

Cirrhosis/liver disease/liver failure

  • May have general jaundice, scratch marks, obvious abdomen distension
  • Leukonychia
  • Clubbing
  • Palmar erythema
  • Dupytron’s contracture (usually alcohol related)
  • Hepatic flap (in advanced liver failure)
  • Jaundice of face and eyes
  • Spider naevi, could be anywhere
  • Gynecomastia
  • Liver enlargement, with possible smooth nodules (cirrhosis)
  • Ascites with shifting dullness (hypoalbuminaemia)

 

Portal hypertension

  • Signs of liver disease as above
  • Caput medusa
  • Ascites with shifting dullness

 

Alcoholic related fatty liver disease

  • Dupytron’s contracture
  • Palmar erythema
  • Malar flush
  • Gynecomastia
  • Portal hypertension
  • Enlarged liver less common

 

Gallbladder disease/obstruction

  • Jaundice
  • Pruritis/scratch marks
  • Palpable gall bladder is likely to be malignant

 

 

 

Pancreatic disease

  • Bruising (Grey-Turner’s sign) from pancreatitis

 

Bowel disease

  • Palpable masses – malignancy, Crohn’s disease
  • Clubbing – IBD

 

Kidney disease

  • Palpable kidneys – polycystic kidney disease
  • Ascites – nephrotic syndrome (low protein in the blood, because excreted in the urine)

 

Gastric disease

  • Virchow’s node enlargement – gastric malignancy
  • Epigastric pain

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