Bacterial Cholangitis: Examination

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

• General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further:
  • Inspection (viewing).
    • Skin, mucous membranes and sclerae (white part of the eye) [due topossible symptoms: jaundice].
    • Abdomen (abdomen):
      • Shape of the abdomen?
      • Skin color? Skin texture?
      • Efflorescences (skin changes)?
      • Pulsations? Bowel movements?
      • Visible vessels?
      • Scars? Hernias (fractures)?
  • Auscultation (listening) of the heart.
  • Examination of the lungs
  • Examination of the abdomen:
    • Percussion (tapping) of the abdomen.
      • [Meteorism (flatulence): hypersonoric tapping sound.
      • Cholelithiasis (gallstones): tapping pain over the gallbladder region and the right lower ribcage.
      • Attenuation of the knock due to enlarged liver or spleen, tumor, urinary retention?
      • Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
      • Cholelithiasis (gallstones): tapping pain over the gallbladder region and the right lower ribcage.
    • Palpation (palpation) of the abdomen (abdomen), etc., looking for defensive tension and resistances (pressure pain?, knock pain?, cough pain?, defensive tension?, hernial ports?, renal bearing knock pain?) [often a knock pain is noted over the gallbladder region and the right lower ribcage; pressing and recurrent cramping pain attacks lasting more than 15 minutes, localized in the right upper abdomen and may radiate along the right ribcage into the right scapula; meteorism (flatulence)] [due toPossible causes: cholelithiasis (gallstones)]

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