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Clinical examination of the digestive system.

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Clinical examination of the digestive system can be approached in these sections:
  1. Preparation and general survey
    • Consent, privacy, positioning, exposure, pain assessment
    • General appearance, nutrition, hydration, pallor, jaundice, edema, lymph nodes
  2. Hands, arms, face, and mouth
    • Clubbing, leukonychia, palmar erythema, bruising, asterixis
    • Xanthelasma, scleral icterus, angular stomatitis, oral ulcers, parotid enlargement, fetor hepaticus
  3. Abdominal examination
    • Inspection: contour, scars, striae, dilated veins, umbilicus, visible masses/peristalsis
    • Palpation: tenderness, guarding, masses, liver, spleen, kidneys, aorta, gallbladder
    • Percussion: liver span, splenic percussion, shifting dullness and fluid thrill
    • Auscultation: bowel sounds, bruits
  4. Focused tests
    • Murphy sign, rebound and percussion tenderness
    • Tests for ascites
    • Hernial orifices and external genital examination when relevant
  5. Rectal examination
    • Indications, inspection, digital examination, stool appearance and testing when appropriate
  6. Completion
    • Examine legs for edema, perform urinalysis, and consider examination of other systems, particularly cardiovascular and respiratory systems.
A structured examination is generally: inspect, palpate, percuss, then auscultate. Start palpation away from the painful area, observe the patient’s face throughout, and finish by summarizing positive and negative findings.
Which area would you like in detailed exam-note format: general signs, abdominal examination, ascites/hepatosplenomegaly, rectal examination, or an OSCE-style checklist?
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