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Examination

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The clinical examination in jaundiced patients should search for the features of acute and chronic liver disease.

The following points may be helpful:

  • haemolytic jaundice is a mild yellow colour; hepatocellular jaundice is orange; prolonged biliary obstruction imparts a deep greenish hue

  • cutaneous indicators of cirrhosis include purpura, spider naevi, palmar erythema, and loss of secondary sexual hair

  • cutaneous indicators of chronic cholestasis include scratch marks, pigmentation, finger clubbing, xanthomas

  • ascites suggests cirrhosis or malignant disease

  • hepatomegaly:
    • large, nodular liver suggests cancer
    • large, smooth liver suggests extrahepatic cholestasis
    • small liver may be due to hepatitis or cirrhosis

  • arterial murmur over the liver indicates acute alcoholic hepatitis or primary liver cancer

  • splenomegaly suggests portal hypertension due to cirrhosis

  • palpable gall bladder suggests pancreatic carcinoma

  • dark urine and pale stools suggests cholestasis

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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