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18 Possible Causes for Pulsatile Liver, Tenderness in the Right Upper Quadrant

  • Tricuspid Valve Insufficiency

    Right heart failure leads to ascites, hepatosplenomegaly, pulsatile liver, peripheral edema and pleural overflow. In advanced stages patients are cachectic and cyanotic.[heartupdate.com] Fatigue, weakness, shortness of breath, jugular vein distension, ascites, hepato-splenomegaly, pulsatile liver, pleural effusions and peripheral oedema may be present.[escardio.org] The liver may be large and pulsatile. There is usually a single first heart sound that may be increased in intensity.[patient.info]

  • Cor Pulmonale

    liver, a loud pulmonic component of the 2nd heart sound, or evidence of venous thrombosis.[clinicaladvisor.com] Hepatojugular reflux and pulsatile liver are signs of RV failure with systemic venous congestion. In severe disease, ascites can also be present.[emedicine.medscape.com] […] sickle cell crisis, pre-existing pulmonary hypertension; chronic lung disease; or following cardiac surgery Physical examination may reveal distended neck veins, a tender, pulsatile[clinicaladvisor.com]

  • Chronic Right-Sided Congestive Heart Failure

    liver palpable below the right costal margin; abdominal swelling and ascites; and visible elevation of the jugular venous pressure, sometimes with large a or v waves that[merckmanuals.com] Hepatomegaly liver pulsatility if there is significant associated tricuspid regurgitation. Jaundice in advanced cases. Ascites in advanced cases.[patient.info] […] include nontender peripheral pitting edema (digital pressure leaves visible and palpable imprints, sometimes quite deep) in the feet and ankles; an enlarged and sometimes pulsatile[merckmanuals.com]

  • Acute Cor Pulmonale

    liver, a loud pulmonic component of the 2nd heart sound, or evidence of venous thrombosis.[clinicaladvisor.com] liver and ascites.[phaonlineuniv.org] Hepatojugular reflux and pulsatile liver are signs of RV failure with systemic venous congestion. In severe disease, ascites can also be present.[emedicine.medscape.com]

  • Liver Transplant Rejection

    […] of the normally pulsatile blood flow of the hepatic veins.[ncbi.nlm.nih.gov] 37 transplanted livers (in thirty patients) were assessed by serial doppler ultrasound examination. 18 of 23 biopsy-proved rejection episodes were associated with abrupt damping[ncbi.nlm.nih.gov]

  • Laparoscopic Cholecystectomy

    The apex beat was in the right fifth intercostal space, midclavicular line. She had epigastric tenderness but was not tender in the right or left upper quadrants.[bmcsurg.biomedcentral.com] Pulsatile collaterals suggesting high intravascular pressure seen intra-operatively was challenging.[omicsonline.org] Physical examinations generally reveal moderate fever, tachycardia and marked tenderness in the upper right quadrant. 25% of patients have palpable hydropic gallbladder.[panafrican-med-journal.com]

  • Abdominal Mass

    Gallbladder tumor can cause a moderately tender, irregularly shaped right-upper quadrant mass.[medical-dictionary-search-engines.com] Determine for any mass: site, tenderness, size and shape, surface (irregular or smooth), edge (regular or irregular), consistency (soft or hard), mobility, whether pulsatile[patient.info] Gallbladder tumor can cause a tender, irregularly shaped mass in the right-upper quadrant.[medlineplus.gov]

  • Hepatocellular Carcinoma

    […] failure, tricuspid regurgitation (pulsatile), sickle cell disease, inborn errors of metabolism liver cysts – simple cyst, inherited polycystic kidney/liver disease, hydatid[geekymedics.com] […] failure due to cirrhosis , which may be compensated or decompensated A mass in the liver could be due to: generalised hepatomegaly – acute hepatitis, early cirrhosis, heart[geekymedics.com] […] tumour Differential diagnosis – liver failure/liver mass Other causes of liver failure include: acute liver failure due to hepatitis, drug overdose or other causes chronic liver[geekymedics.com]

  • Hepatic Artery Aneurysm

    However, there was a direct and indirect tenderness over the right upper quadrant and epigastrium with a positive Murphy's sign.[synapse.koreamed.org] Physical examination may reveal a pulsatile mass or abdominal bruit, but is usually normal.[eurorad.org] There was tenderness to palpation over the right upper quadrant and epigastrium. He did not have any rebound tenderness and Murphy's sign was negative.[kjim.org]

  • Hepatosplenic Amyloidosis

    On physical examination, direct tenderness in the left chest and right upper quadrant of the abdomen was found.[synapse.koreamed.org] On palpation Smooth hepatomegaly Suggests: hepatitis, chronic heart failure, sarcoid, early alcoholic cirrhosis, tricuspid incompetence with a pulsatile liver.[patient.info] Measure the hepatomegaly by percussing the upper and lower borders (will rule out causes such as emphysema which can push the liver down giving a false impression of hepatomegaly[patient.info]

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