Pancreatic Cancer: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin, mucous membranes, and sclerae (white part of the eye) [due tosymptom: painless icterus (jaundice; occlusive icterus?* ), pruritus (itching)]
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
    • Inspection and palpation (palpation)
      • Lymph node stations (cervical, axillary, supraclavicular, inguinal).
      • Spine [due tosymptom: annular back pain without orthopedic cause].
      • Extremities [due tosymptoms: thrombophlebitis (inflammation of superficial veins), thrombosis]
    • Auscultation (listening) of the heart.
    • Auscultation of the lungs
    • Examination of the abdomen (belly)
      • Percussion (on palpation) of the abdomen [ascites (abdominal fluid)?, splenomegaly (splenomegaly)?]
        • Ascites: Fluctuating wave phenomenon. This can be triggered as follows: if you tap against one flank a wave of fluid is transmitted to the other flank, which can be felt by placing the hand on it (undulation phenomenon); flank attenuation.
        • Meteorism (flatulence): hypersonoric tapping sound.
        • Attenuation of the tapping sound due to enlarged liver or spleen, tumor, urinary retention?
        • Hepatomegaly and/or splenomegaly: estimate liver and spleen size.
      • Palpation (palpation) of the abdomen, etc. [due tosymptoms: painless enlarged bulging elastic gallbladder?* ; upper abdominal pain – radiating mainly to the right flank, back or left shoulder blade; splenomegaly?]
  • Health check (as an additional follow-up measure).

* Courvoisier sign

Square brackets [ ] indicate possible pathological (pathological) physical findings.