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).
- 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 abdomen (abdomen)
- Percussion (tapping) of the abdomen
- Meteorism (flatulence): hypersonoric tapping sound.
- Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?
- [due todifferential diagnoses: cholelithiasis (gallstones): tapping pain over gallbladder region and right lower rib].
- Palpation (palpation) of the abdomen (abdomen) pressure pain?, knock pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?) [pain in the upper abdomen (often occurs after food intake (food-dependent pain); possibly also occurring independently of food intake)][due todifferential diagnoses:
- Functional dyspepsia (irritable stomach syndrome).
- Gastritis (gastritis)
- Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
- Ulcus duodeni (duodenal ulcer)]
- Percussion (tapping) of the abdomen
- Inspection (viewing).
- Cancer screening[due todifferential diagnoses:
- Gastric carcinoma (stomach cancer)
- Pancreatic carcinoma (pancreatic cancer)]
[due topossible sequelae:
- Gastric carcinoma (stomach cancer)
- MALT lymphoma (lymphoma of the mucosa-associated lymphoid tissue, MALT); so-called extranodal (arising outside the lymph nodes) lymphomas; about 50% of all MALT lymphomas are diagnosed in the stomach (80% in the gastrointestinal tract); MALT lymphomas are highly favored in their development by chronic infections with the bacterium Helicobacter pylori resp. favored by inflammation; by an Erdikationstherapie (antibiotic therapy) disappear not only the bacteria, but as a result in 75% of cases also the gastric lymphoma]
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.