What physical exam finding is commonly associated with primary biliary cirrhosis?

Primary biliary cirrhosis, now more commonly referred to as primary biliary cholangitis, is characterized by the progressive destruction of the bile ducts within the liver. This condition leads to biliary obstruction, cholestasis, and eventually cirrhosis. One of the fundamental physical examination findings in a patient with primary biliary cirrhosis is hepatomegaly.

Hepatomegaly occurs because the liver becomes inflamed and enlarged due to the accumulation of bile and its metabolites as a result of the damaged bile ducts. As the disease progresses, a patient may present with a larger-than-normal liver upon examination. The enlargement of the liver can also reflect the compensatory response of the liver to the underlying inflammation and fibrotic changes.

While splenomegaly, ascites, and signs related to cholecystitis (like Murphy's sign) can occur in various liver diseases, they are not as consistently associated with primary biliary cirrhosis as hepatomegaly. Splenomegaly may occur due to portal hypertension but is not a direct finding in earlier stages of primary biliary cholangitis. Ascites typically develops due to decompensated liver disease or advanced cir