gland enlargement in alcoholic cirrhosis

Q: Which of the following gland enlargement can be seen in advanced alcohol-associated cirrhosis? - select one

A) Parotid gland 

B) Salivary Gland

Answer: A

This question aims to raise awareness of the clinical importance of physical exams and "a physician touch" in clinical medicine.

Even various stigmata of liver failure can guide physicians to the specific etiology of cirrhosis. Three primary organ dysfunctions are highly likely to be seen in advanced alcohol-associated cirrhosis (though they  can be present in other types of cirrhosis)

• Dupuytren contractures
• Parotid gland enlargement
• Testicular atrophy

Although parotid gland enlargement in chronic alcoholism is known since alcohol was known to humankind, it was first reported in present-day literature in 1957 and has been consistently described.

#hepatology

#physical-exam

References:

1. Stanley J. Wolfe, M.D., W. H. J. Summerskill, D.M., M.R.C.P., and Charles S. Davidson, M.D.- Parotid Swelling, Alcoholism and Cirrhosis, Published March 14, 1957, N Engl J Med 1957; VOL. 256 NO. 11,256:491-495, DOI: 10.1056/NEJM195703142561103

2. Dutta SK, Dukehart M, Narang A, Latham PS. Functional and structural changes in parotid glands of alcoholic cirrhotic patients. Gastroenterology. 1989 Feb;96(2 Pt 1):510-8. doi: 10.1016/0016-5085(89)91578-3. PMID: 2910764.