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)?
- Inspection and palpation (palpation) of the neck [due todifferential diagnosis: hyperthyroidism (hyperthyroidism)].
- Auscultation (listening) of the heart
- Auscultation of the lungs
- Palpation (palpation) of the abdomen (abdomen) with an attempt to palpate the liver (tenderness?, tapping pain?, coughing pain?, guarding?, hernial ports?, kidney bearing tapping pain?) [Abdominal discomfort (abdominal pain); meteorism (flatulence)][due todifferential diagnoses:
- Liver cirrhosis (connective tissue remodeling of the liver with functional impairment).
- Viral hepatitis (liver inflammation]
- Digital rectal examination (DRU): examination of the rectum (rectum)[due todifferential diagnoses:
- Anal incontinence (fecal incontinence) – inability to retain stool.
- Proctitis (rectal inflammation]
[due topossible secondary diseases:
- Fistula formation
- Stenosis (narrowing)
- Ulcers (ulcers)]
- Inspection (viewing).
- Cancer screening [due todifferential diagnosis: colon carcinoma (colorectal cancer)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.