Gallbladder palpation

The gallbladder palpation test is an auxiliary examination method for checking whether the abdominal gallbladder is normal. Normally, the gallbladder is hidden under the liver and cannot be touched. When the gallbladder enlarges, it exceeds the liver margin and the costal margin. At this time, it can be touched at the outer edge of the lower rectus abdominis of the right costal margin. It can be performed with one-handed palpation palpation or hook finger palpation. The palpation method is palpated with the liver. In the palpation of the gallbladder, in addition to pay attention to the gallbladder with or without swelling, the gallbladder texture, but also to detect the gallbladder with or without tenderness, gallbladder enlargement varies with the nature of the disease. Sometimes the gallbladder has inflammation, and there is no swelling or swelling to the costal margin. The gallbladder cannot be found by palpation. At this point, the gallbladder can be detected. Basic Information Specialist classification: Digestive examination classification: other examinations Applicable gender: whether men and women apply fasting: not fasting Tips: Keep a normal mindset. Normal value Normally, the gallbladder is hidden under the liver and cannot be touched. The normal physiological position of the gallbladder, the human gallbladder is located in the gallbladder fossa in the lower part of the liver, pear-shaped, about 8 to 12 cm long, about 3 to 5 cm wide, and the volume is about 40 to 60 ml. Clinical significance Abnormal results: 1) Gallbladder enlargement, sac sexy, and obvious tenderness (Murphy sign positive), common in acute cholecystitis. 2) gallbladder enlargement, sac sexy, but no tenderness, seen in the periampullary cancer 3) gallbladder enlargement, there are real sexy, can be seen in gallstones or gallbladder cancer. 3) The gallbladder is significantly enlarged, with progressive deepening and obvious jaundice, but no tenderness, called Courvoiusier sign positive, found in pancreatic head cancer. This is caused by progressive compression of the common bile duct in the head cancer of the pancreas. 4) When the common bile duct biliary obstruction, obvious jaundice can also occur, but the gallbladder is often not swollen, because the gallbladder has many chronic inflammation, the cyst wall shrinks due to fibrosis, and it is stuck with the surrounding tissue and loses mobility. . People who need to be examined: routine physical examination items, abnormal abdominals. Precautions Requirements for examination: At the time of examination, the physician placed the left palm flat on the lower right chest of the patient, and the thumb finger was pressed against the point of the lower rib cage of the right rib, and then the patient slowly inhales deeply. When the inflamed gallbladder moves down during inhalation and hits the thumb with hard force, it can cause pain. This is the gallbladder tenderness. For example, when the inhalation is deep, the patient feels pain and stops the inhalation and is called Murphy. Inspection process (1) Palpation of gallbladder enlargement: When the gallbladder enlargement is obvious, the outer edge of the right rectus abdominis muscle may touch a mass with a pear-shaped or oval-shaped tension, and move up and down with the breath, and the lesion is visually observed. Nature depends. If it is not swollen below the costal margin, the cyst cannot be found at the time of palpation. At this point, the gallbladder can be detected for tenderness. (2) Gallbladder tenderness examination method: the patient takes the supine position and the abdominal wall is relaxed. The examiner places the left palm flat on the lower part of the right rib of the patient, and the thumb is pressed against the point of the lower rib cage of the right rib. Qi, when the inflamed gallbladder moves down during inhalation and hits the thumb pressed hard, it can cause pain, which is the tenderness of the gallbladder. For example, due to severe pain, the inhalation is called positive for gallbladder tenderness, and it is also called Murphy. Common in acute cholecystitis. Not suitable for the crowd Inappropriate people: Basically no suitable for the crowd, but people with mental disorders should pay attention. Adverse reactions and risks Nothing.

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