hepatic fricative
Introduction
Introduction During the examination, the palm of your right hand is lightly attached to the liver area, allowing the patient to perform abdominal breathing exercises. There is no friction under the palm when normal. In perihepatic inflammation, the surface of the liver and adjacent peritoneum may become rough due to the presence of cellulosic exudates. The mutual friction between the two can be touched by hand, which is the sense of friction in the liver area. As mentioned above, the liver area friction sound can also be heard during auscultation. The liver area friction sound is audible on the surface of the liver area, suggesting that the liver membrane is invaded by the tumor. Hepatic vascular murmur, liver area friction sound, is a sign of cirrhosis. Cirrhosis is a clinically common chronic progressive liver disease with diffuse liver damage caused by long-term or repeated action of one or more causes.
Cause
Cause
1. Perihepatitis is a kind of inflammation of the liver capsule and subcapsular connective tissue caused by pathogenic pathogens such as Neisseria gonorrhoeae and Chlamydia trachomatis. Also known as FitZ-Hugh-CurtiS syndrome. The disease was first described by Stajan in 1920. Subsequently, CurtiS reported a string-like or band-like adhesion between the front of the liver and the peritoneal wall, which was associated with concurrent gonococcal pelvic inflammatory disease. In 1934, Fit2-Hugh reported 3 cases and demonstrated that perihepatic inflammation is a complication caused by gonococcal infection. Later, there were reports of infection with Chlamydia trachomatis. In 1970, gonococcal and chlamydia infections were considered to be the main cause of sexually transmitted perihepatitis. The pathogens of this disease are mainly Neisseria gonorrhoeae and Chlamydia trachomatis. More common in women, the average age of onset is 15 to 25 years old. 20% of acute salpingitis will be complicated by sexually transmitted perihepatitis. There are only a few reports of men. The disease mainly spreads from the abdominal infection to the surface of the liver. The main route of transmission is direct dissemination of peritoneal lesions, which are transmitted by lymphatics and transmitted by blood.
2. Cancer cells invade the surface of the liver and the adjacent peritoneum, which may become rough due to fibrinous exudates.
Examine
an examination
Related inspection
Determination of liver disease by ultrasonic amino acid clearance
During the examination, the palm of your right hand is lightly attached to the liver area, allowing the patient to perform abdominal breathing exercises. There is no friction under the palm when normal. In perihepatic inflammation, the surface of the liver and adjacent peritoneum may become rough due to the presence of cellulosic exudates. The mutual friction between the two can be touched by hand, which is the sense of friction in the liver area. As mentioned above, the liver area friction sound can also be heard during auscultation. Hepatic vascular murmur, liver area friction sound, is a sign of cirrhosis.
Diagnosis
Differential diagnosis
Hepatosplenomegaly
Liver splenomegaly caused by blood diseases and metabolic diseases, liver biopsy can be done if necessary.
2. Ascites
There are many causes of peritoneal effusion, such as tuberculous peritonitis, constrictive pericarditis, and chronic glomerulonephritis. According to the history and clinical manifestations, related examinations and examination of ascites, it is not difficult to identify with cirrhosis and peritoneal effusion. Laparoscopy can often be diagnosed if necessary.
3. Cirrhosis complications
Differential diagnosis of gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, and the like.
