Pancreatic palpation

The pancreatic palpation test is an auxiliary examination method for checking whether the abdominal pancreas is normal. The pancreas is located behind the retroperitoneum and is deep and soft, so it cannot be touched. In the upper abdomen is equivalent to the first and second lumbar vertebrae, the head of the pancreas and the neck of the pancreas are about the center line, and the tail of the pancreas is on the left side of the midline. When the pancreas has lesions, signs can appear in the upper abdomen. The doctor judges whether the pancreas is normal or not based on the patient's reaction and feel during palpation. Basic Information Specialist classification: Digestive examination classification: physical examination Applicable gender: whether men and women apply fasting: not fasting Tips: Inappropriate people: Basically no suitable for the crowd, but people with mental disorders should pay attention. Normal value The pancreas is located behind the retroperitoneum and is deep and soft in place and cannot be accessed under normal conditions. The pancreas is a large and slender grape-like gland. The normal physiological position of the pancreas is transverse to the stomach, between the spleen and the duodenum; the right end (pancreatic head) is larger, downward, and the left end ( The tail of the pancreas is horizontal and the tail is against the spleen. The exocrine or pancreatic juice of the pancreas is input into the duodenum through the pancreatic duct, which contains various digestive enzymes. Clinical significance Abnormal results Pancreatic abnormalities may have the following conditions (1) Pancreatitis: In the middle of the upper abdomen or the left upper abdomen, there are transverse band-shaped tenderness and muscle tension, and involve the left lower back, suggesting acute pancreatitis; if there is a subcutaneous hemorrhage in the left lower part and blue, it suggests hemorrhagic pancreatitis . If the department touches a hard and non-moving mass, such as a transverse strip, it should be considered as chronic pancreatitis. (2) Pancreatic cancer: If there is a hard block in the middle of the upper abdomen or the upper left abdomen, the surface is not smooth like a nodule, the possibility of pancreatic cancer should be considered. Painful jaundice (courvoisier sign) can occur in the head of the pancreas. (3) pancreatic pseudocyst: cystic mass is touched under the upper abdomen or left upper abdomen, such as fixed position, smooth surface, no tenderness is mostly pancreatic pseudocyst. However, because the stomach is in front of the pancreas, the tumor is found in this area to be differentiated from the mass on the stomach wall. Regular physical examination items for people who need to be examined, abnormal abdominals. Precautions Requirements for examination: 1 In order to avoid the abdominal muscle tension of the examinee, the examiner may first place the palm on the abdominal wall, so that the examinee can adapt to the moment and then palpate the examination; 2 the test can simultaneously talk with the examinee, transfer Its attention, reduce abdominal muscle tension; 3 various palpation techniques should be combined with different examination sites, flexible application. Inspection process In the upper abdomen is equivalent to the first and second lumbar vertebrae, the head of the pancreas and the neck of the pancreas are about the center line, and the tail of the pancreas is on the left side of the midline. When the pancreas has lesions, signs can appear in the upper abdomen. In the middle of the upper abdomen or the upper left abdomen, there are transverse band-shaped tenderness and muscle tension, and involve the left lower waist, suggesting inflammation of the pancreas; if the onset is acute and there is a blue blood in the left lower part of the skin, it suggests hemorrhagic pancreatitis. Chronic pancreatitis should be considered when the upper abdomen touches a mass that is hard and has no mobility. If it has a hard block and the surface is not smooth like a nodule, it may be pancreatic cancer. Occurred in the head of the pancreas, painless jaundice and gallbladder enlargement (ie, Courvoisier sign positive). Cystic masses are found under the upper abdomen or the upper left abdomen, mostly pancreatic pseudocysts. However, it is necessary to pay attention to the stomach in front of the pancreas, so the tumor in this area needs to be differentiated from the stomach tumor. Not suitable for the crowd Inappropriate people: Basically no suitable for the crowd, but people with mental disorders should pay attention.