Gallbladder cancer physical examination

Gallbladder cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Gallbladder cancer from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

MRI

Echocardiography and Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Palliative Treatment

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Gallbladder cancer physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Gallbladder cancer physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Gallbladder cancer physical examination

CDC on Gallbladder cancer physical examination

Gallbladder cancer physical examination in the news

Blogs on Gallbladder cancer physical examination

Directions to Hospitals Treating Gallbladder cancer

Risk calculators and risk factors for Gallbladder cancer physical examination

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

## Overview

[edit | edit source]

Patients with gallbladder cancer usually appear asymptomatic. Physical examination of patients with gallbladder cancer is usually remarkable for nonspecific symptoms that are due to cholelithiasis or cholecystitis. The preoperative diagnosis rate for gallbladder cancer was only 10 to 15 percent.

## Physical Examination

[edit | edit source]

* Physical examination of patients with gallbladder cancer is usually non specific or most oftenly asymptomatic.[1][2][3][4][5]
* Physical examination of patients with gallbladder cancer is usually remarkable for symptoms that are due to cholelithiasis or cholecystitis.

### Appearance of the Patient

[edit | edit source]

* Patients with gallbladder cancer usually appear anorexic.

### Vital Signs

[edit | edit source]

* Fever
* Tachycardia

### Skin

[edit | edit source]

* Dry skin
* Yellowish discoloration of skin in severe jaundice

### Abdominal Examination

[edit | edit source]

* Right upper quadrant abdominal tenderness
* Courvoisier's sign: also called Courvoisier's Law is a sign of malignancy either pancreatic or of gallbladder origin rather than a sigh of cholelithiasis.[1]
* Mirizzi syndrome: when gallbladder cancer invades biliary tree or the region of the hepatoduodenal ligament, patients present with obstructive jaundice.The presence of obstructive jaundice on is highly suggestive of compression of the common hepatic duct due to impacted stone in the gallbladder neck.[6][7]
* The presence of palpable mass, ascites or paraneoplastic syndromes like acanthosis nigricans on physical examination is most likely suggestive of extra abdominal metastases.

## References

[edit | edit source]

1. ↑ 1.0 1.1 Fitzgerald JE, White MJ, Lobo DN (2009). "Courvoisier's gallbladder: law or sign?". World J Surg. 33 (4): 886–91. doi:10.1007/s00268-008-9908-y. PMID 19190960.
2. ↑ Agrawal S, Vohra S (2017). "Simultaneous Courvoisier's and double duct signs". World J Gastrointest Endosc. 9 (8): 425–427. doi:10.4253/wjge.v9.i8.425. PMC 5565509. PMID 28874964.
3. ↑ Memon AA, Soomro MI, Soomro QA (2012). "Courvoisier's law revisited". J Coll Physicians Surg Pak. 22 (6): 392–4. doi:06.2012/JCPSP.392394 Check `|doi=` value (help). PMID 22630101.
4. ↑ Gorelik O, Shteinschnaider M, Cohen N, Almoznino-Sarafian D (2013). "[Visible Courvoisier's sign: a rare presentation of bile duct obstruction]". Harefuah (in Hebrew). 152 (9): 516–7, 565. PMID 24364089.CS1 maint: Unrecognized language (link)
5. ↑ Munzer D (1999). "Assessment of Courvoisier's law". Saudi J Gastroenterol. 5 (3): 106–12. PMID 19864733.
6. ↑ Witte CL (1984). "Choledochal obstruction by cystic duct stone. Mirizzi's syndrome". Am Surg. 50 (5): 241–3. PMID 6721287.
7. ↑ Starling JR, Matallana RH (1980). "Benign mechanical obstruction of the common hepatic duct (Mirizzi syndrome)". Surgery. 88 (5): 737–40. PMID 7434217.

Template:WikiDoc Sources