Stomach cancer physical examination

Patients with stomach cancer generally appear weak. Common physical examination findings include abdominal distention, palpation of an abdominal mass, and pallor. Leser-Trelat sign and presence of Virchow’s node (left supraclavicular lymphadenopathy), Sister Mary Joseph nodule (visible periumbilical nodule), Blumer’s shelf (rectal mass/shelf on rectal exam) and/or Trousseau’s syndrome (migratory phlebitis) on physical examination are highly suggestive of stomach cancer

• Patients with gastric cancer are generally weak due to weight loss.

• Pallor.
• Jaundice may appear if bile duct obstruction occurs.^[1]
• Acanthosis nigricans: Velvety and hyperpigmented patches on skin folds.^[2]
• Leser-Trelat sign: Acute-onset multiple seborrheic keratosis lesions that are usually located on the patient’s back.^[3]

• Virchow’s node: Left supraclavicular adenopathy.^[4]

• The presence of a palpable abdominal mass is the most common physical finding.^[5]

• Abdominal distention.
• Sister Mary Joseph nodule: A visible periumbilical nodule that is highly suggestive of umbilical metastasis.
• Splenomegaly.
• Ascites: It can be the first indication of peritoneal carcinomatosis.
• A palpable liver mass: It is often multifocal or diffuse, usually associated with an elevation in the serum alkaline phosphatase concentration.

• Blood on rectal exam.
• Blumer’s shelf: Rectal mass/shelf palpable on rectal exam.^[6]

• Ovarian mass may be suggestive of Krukenberg syndome.^[7]

• Muscle weakness.

• Microangiopathic hemolytic anemia.^[8]
• Membranous nephropathy.^[9]
• Trousseau’s syndrome: Hypercoagulable states.^[10]
• Polyarteritis nodosa.^[11]

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