ABDOMINAL INSPECTION

ABDOMINAL INSPECTION

The following images are an exposition part that i'd do.

When the doctor is doing the abdominal inspection, there are certain cases in which is possible speculate the diagnosis.

Courvoisier-Terrier Sign

If a patient had a visible and palpable gallblader and jaundice, the physician can think in pancreas head carcinoma with a 95% specifity. This is due to biliary duct obstruction by a mass.


Cullen Sign

If a patient has a periumbilical ecchymosis, got Cullen sign due to retroperitoneal bleeding that goes thorugh the falciform ligament, and pass till subcutaneus tissue due to conective tissue of the redondus ligament. This is unusual but indicate an acute pancreatitis.

Turner Sign

If a patient has a flank ecchymosis got the turner sign (also called Grey-turner). This happens due to para-renal space bleeding that goes with the quadratus lumborum muscle and pass through the flank muscle fascia, probably for a defect of the fascia. Lastly, the blood pass through the subcutaneous tissue. This is also unusual and indicate acute pancreatitis.


Erythema Ab igne

If a patient has a brown livedo reticularis-like pigmentation, the doctor could think in two possible options: a physical damage of the skin (e.g. heat exposure) and a chronic pancreatitis.




Sister Mary Joseph's Nodule

Metastasic cancer of the umbilillicus associated with gastrointestinal and ovarian tumors. This condition was named for Sister Mary Joseph (1856–1939), a surgical assistant for Dr. William
Mayo, who noted the association between paraumbilical nodules observed during skin
preparation for surgery and metastatic intraabdominal cancer confirmed at surgery.



References

- Sopeña Bernardo et all; Visible gallbladder. Medical images; 2007

- Mok Daniel H M et all; Erythema Ab igne in chronic pancreatitis: a diagnostic sign; Journal of royal society of medicine; 1984

- Mookadam Farouk et all; Cullen’s and turner’s signs; NEJM; 2005

- Kanter, Judith et all. Sister Mary Joseph's Nodule - NEJM