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Abdominal conditions signs

Clinical examination > Abdominal

Chronic liver disease

  • Clubbing
  • Leukonychia
  • Palmar erythema
  • Dupuytren’s contracture
  • Jaundice
  • Spider naevi
  • Gynaecomastia
  • Loss of axillary hair
  • Distended abdominal wall veins/‘caput medusae’ (portal hypertension)
  • Hepatomegaly (but liver is often small in cirrhosis) 
  • Splenomegaly (portal hypertension)
  • Ascites

Transplanted kidney

  • Old AV fistula 
  • Rutherford-Morrison scar (usually RIF)
  • Smooth mass underlying scar (transplanted kidney)

Hepatosplenomegaly

  • Hepatomegaly/splenomegaly/both

Polycystic kidneys

  • AV fistula (if undergone dialysis)
  • Hypertension
  • Pale conjunctiva (anaemia)
  • Flank scar (if either kidney has been removed)
  • Bilateral ballotable flank masses
  • Hepatomegaly (hepatic cysts)

Liver transplant

  • Signs of chronic liver disease (but most resolve)
  • Mercedes Benz modification scar      

Combined kidney-pancreas transplant

  • LIF scar (renal graft)
  • RIF scar (pancreas graft)
  • Smooth mass underlying LIF scar (transplanted kidney)

Polycythaemia rubra vera

  • Dusky cyanosis
  • Hypertension
  • Facial plethora
  • Splenomegaly

Hereditary spherocytosis

  • Pale conjunctiva
  • Mild jaundice
  • Splenomegaly

Primary biliary cholangitis

  • Middle-aged female
  • Jaundice
  • Skin hyperpigmentation
  • Excoriations
  • Xanthelasma
  • Hepatomegaly

Try some questions!

Please list some extra-renal signs of polycystic kidney disease

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Which conditions can cause secondary polycythaemia?

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A middle-aged female presents to you with jaundice and hepatomegaly, which conditions would you include in your differential diagnosis?

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What are the main ways to prevent graft rejection after renal transplantation?

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And some stations…

  1. Chronic liver disease
  2. Renal transplant
  3. Hepatosplenomegaly
  4. Find more here!

Picture references

Clubbing: 2009 Desherinka, licensed under the Creative Commons Attribution-Share Alike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/), 3.0 Unported (https://creativecommons.org/licenses/by-sa/3.0/deed.en), 2.5 Generic (https://creativecommons.org/licenses/by-sa/2.5/deed.en), 2.0 Generic (https://creativecommons.org/licenses/by-sa/2.0/deed.en) and 1.0 Generic license (https://creativecommons.org/licenses/by-sa/1.0/deed.en) and GNU Free Documentation licence 1.2 (https://commons.wikimedia.org/wiki/Commons:GNU_Free_Documentation_License,_version_1.2). Sourced from: https://en.wikipedia.org/wiki/Nail_clubbing#/media/File:Dedos_con_acropaquia.jpg

Dupuytren’s contracture: 2006 Frank C. Müller, Baden-Baden. Licensed under the Creative Commons Attribution-Share Alike 4.0 International license (https://creativecommons.org/licenses/by-sa/4.0/deed.en). Sourced from: https://commons.wikimedia.org/wiki/File:Morbus_dupuytren_fcm.jpg

Ascites (second photo): 2011. James Heilman, MD. Licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license (https://creativecommons.org/licenses/by-sa/3.0/deed.en). Sourced from: https://commons.wikimedia.org/wiki/File:Hepaticfailure.jpg

Abdominal

One Comment

  1. Islam Berkemajuan says:
    10 August 2023 at 02:22

    Thank you for the comprehensive notes on this website. The information you’ve provided has made studying so much easier, and I’m truly grateful. Thanks!

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