Inspection, Palpation, Percussion And Auscultation

There are four tools of clinical examination: inspection, palpation, percussion and auscultation (“Clinical assessment,” n.d.). During a doctor’s inspection of a patient, he or she will want to look at patients with determination and knowledge of potential findings. This can be in the form of acknowledging how the patient walks, looks, acts or even dresses. Inspection is used the most to help diagnose patients with cholangiocarcinoma. According to Kowdley, Lowe, Afdhal, and Anderson (2017), 90% of patients with cholangiocarcinoma will appear jaundice. They may have dark urine or clay-colored stool. Some may experience dull, constant abdominal pain, weight loss, or fever. Palpation can be used to access size, borders, temperature and ability to move. Palpation may be used to detect hepatomegaly in some patients with cholangiocarcinoma. Kowdley, et al. (2017), further states that 25 to 40% of cholangiocarcinoma patients have hepatomegaly. On rare occasion is may be used to detect a palpable gallbladder. …show more content…
If a patient is jaundiced a doctor will most likely send them to get an abdominal ultrasound done to access biliary dilatation and determine if gallstones are present. This may also help determine the site of obstruction. If ultrasound cannot rule out the direct cause of jaundice then axial imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) will be performed. Tumors can be identified and staged by endoscopic studies determined by where the lesion is. If the lesion is within the proximal biliary tree then a percutaneous transhepatic cholangiography (PTC) can be used. If the lesion is within the distal biliary tree, endoscopic ultrasound (EUS) should be used. Ultimately, no matter what imaging technique is used, true resectability can only be discovered through a complete abdominal exploratory