A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; furthermore:
- Inspection (viewing).
- Skin, mucous membranes and sclerae (white part of the eye).
- 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 [due todifferential diagnosis: myocardial infarction (heart attack)].
- Auscultation of the lungs
- Examination of the abdomen (belly)
- Percussion (tapping) of the abdomen
- Meteorism (flatulence): hypersonoric tapping sound.
- Attenuation of tapping sound 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) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?).
- [due toPossible sequelae of acute gastritis as well as type A gastritis: ulcus ventriculi (gastric ulcer) and as a result there may be gastric perforation or life-threatening gastric bleeding, manifested by vomiting blood (hematemesis) or tarry stools (melena)][due toDifferential diagnoses:
- Appendicitis (inflammation of the appendix).
- Cholecystitis (gallbladder inflammation)
- Small intestinal obstruction (narrowing of the small intestine due to inflammation, tumor or foreign body).
- Functional dyspepsia (irritable stomach syndrome).
- Biliary colic
- Pancreatitis (inflammation of the pancreas)
- Ulcus duodeni (duodenal ulcer)
- Ulcus ventriculi (gastric ulcer)]
- Percussion (tapping) of the abdomen
- Digital rectal examination (DRU): examination of the rectum (rectum) [due todifferential diagnosis: colon obstruction (narrowing of the colon due to inflammation, tumor or foreign body)].
- Inspection (viewing).
- Cancer screening [due todifferential diagnoses: gastric carcinoma (stomach cancer); pancreatic carcinoma (pancreatic cancer)]
- If necessary, neurological examination [due topossible secondary disease of type A gastritis: polyneuropathy].
- If necessary, psychiatric examination [due topossible secondary disease of type A gastritis: depression].
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.