
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Alcoholic liver disease physical examination
Introduction
Overview
Overview
There are certain stigmata associated with alcoholic liver disease that one should look for on physical examination. These include; jaundice, gynecomastia, spider angiomata, bruising, hepatosplenomegaly, ascites, testicular atrophy, asterixis, and palmar erythema. A thorough neurologic and mental status exam should also be done to assess for signs of hepatic encephalopathy, or other neurologic deficits that may be caused by chronic alcohol use.
Physical Examination
Physical Examination
Physical examination of alcoholic liver disease includes:[1][2][3][4][5][6][7][8][9][10]
Vitals
- Fever may be present
Head and Neck
- Fetor hepaticus (breath smelling like a freshly opened corpse)
- Parotid hypertrophy
- Poor dentition
- Scleral icterus
Skin
- Jaundice
- Abnormal dark or light patches of skin
- Spider angiomata
- Gynecomastia
- Bruising or other indications of thrombocytopenia
- Striae
Abdomen
- Hepatosplenomegaly
- Abdominal distention
- Palpable liver edge
- Abdominal tenderness
- Ascites
- Fluid wave (due to ascites)
- Right upper quadrant tenderness
Genitourinary
Extremities
Neurologic
- Confusion, coma (encephalopathy) may be present
- Evidence of Wernicke’s or Korsakoff’s syndrome
References
References
- β Baraona E, Leo MA, Borowsky SA, Lieber CS (1975). “Alcoholic hepatomegaly: accumulation of protein in the liver”. Science. 190 (4216): 794β5. PMIDΒ 1198096.
- β Akriviadis E, Botla R, Briggs W, Han S, Reynolds T, Shakil O (2000). “Pentoxifylline improves short-term survival in severe acute alcoholic hepatitis: a double-blind, placebo-controlled trial”. Gastroenterology. 119 (6): 1637β48. PMIDΒ 11113085.
- β Mendenhall CL, Anderson S, Weesner RE, Goldberg SJ, Crolic KA (1984). “Protein-calorie malnutrition associated with alcoholic hepatitis. Veterans Administration Cooperative Study Group on Alcoholic Hepatitis”. Am. J. Med. 76 (2): 211β22. PMIDΒ 6421159.
- β Pirovino M, Linder R, Boss C, KΓΆchli HP, Mahler F (1988). “Cutaneous spider nevi in liver cirrhosis: capillary microscopical and hormonal investigations”. Klin. Wochenschr. 66 (7): 298β302. PMIDΒ 3131572.
- β Dutta SK, Dukehart M, Narang A, Latham PS (1989). “Functional and structural changes in parotid glands of alcoholic cirrhotic patients”. Gastroenterology. 96 (2 Pt 1): 510β8. PMIDΒ 2910764.
- β Van Thiel DH, Gavaler JS, Schade RR (1985). “Liver disease and the hypothalamic pituitary gonadal axis”. Semin. Liver Dis. 5 (1): 35β45. doi:10.1055/s-2008-1041756. PMIDΒ 3983651.
- β Epstein O, Dick R, Sherlock S (1981). “Prospective study of periostitis and finger clubbing in primary biliary cirrhosis and other forms of chronic liver disease”. Gut. 22 (3): 203β6. PMCΒ 1419499. PMIDΒ 7227854.
- β Attali P, Ink O, Pelletier G, Vernier C, Jean F, Moulton L, Etienne JP (1987). “Dupuytren’s contracture, alcohol consumption, and chronic liver disease”. Arch. Intern. Med. 147 (6): 1065β7. PMIDΒ 3592873.
- β Erlinger S, Benhamou J. Cirrhosis: clinical aspects. In: Mcintyre N, Benhamou J, Rizzetto M, editors. Oxford textbook of clinical hepatology. Oxford: University Press; 1991. p. 380.
- β Groszman R, Franchis R. Portal hypertension. In: Schiff E, Sorrell M, Maddrey W, editors. Diseases of the liver. Philadelphia: Lippincot Williams & Wilkens; 1999. p. 415.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2] Charmaine Patel, M.D. [3]
