ABDOMINAL MASS

INTRODUCTIONAn abdominal mass is any localized enlargement

or swelling in the abdomen. Depending on its location, the abdominal mass may be caused by an enlarged liver (hepatomegaly), enlarged spleen (splenomegaly), protruding kidney, a pancreatic mass, aretroperitoneal mass (a mass in the posterior of the peritoneum), an abdominal aortic aneurysm, or various tumours, such as those caused by abdominal carcinomatosis and omental metastasis. The treatments depend on the cause, and may range from watchful waiting to radical surgery.

SYMPTOMSMany abdominal masses are

discovered incidentally during routine physical examination.An abdominal mass may accompany

other symptoms, which will vary depending on the underlying disease.

Common symptoms that may occur along with an abdominal mass:

1-Abdominal pain

SYMPTOMS CONT.2-Change in appetite3- frequency, dysuria ,polyuria4-Changes bowel habit 5-Rapid weight loss or weight gain

6- fever,sweating7-nausea, vomiting 8- fullness9-hematuria10-appearance of mass

SYMPTOM CONT.

Serious symptoms that might indicate a life-threatening condition

1-Abdominal mass that is growing rapidly

2-Abdominal mass that is pulsating3-New abdominal mass accompanied

by severe abdominal pain

POTENTIAL COMPLICATIONS OF AN ABDOMINAL MASS

1-Ascites 2-Gastrointestinal perforation and sepsis3-Incontinence4-Infertility due to permanent damage to the

reproductive tract5-Permanent kidney damage6-Permanent liver damage7-Permanent pancreas damage8-Ruptured aortic aneurysm9-Secondary obstruction of the small and large

intestine10-metastasis in case of CA11-Spread of infection

DDX

Medications That May Cause Lymphadenopathy

Allopurinol Atenolol Captopril Carbamazepine Cephalosporins Gold Hydralazine 

DIAGNOSIS

1-history: Important clues in history include weight loss ,diarrhea  ,abdominal pain

2-physical examination, the clinician must identify 1-location of the mass. 2-whether it is rigid or mobile. 3-Presence of pulsation or peristalsis.

DIAGNOSIS CONT.4-important sign:1-tenderness2-yellowish discoloration of skin& sclera3-anemia4-raccon eye5-oedema6-lymphadenopathy7-localized or generalized enlargment of

abdomen

DIAGNOSIS CONT.8-dullness on percussion9-ecchymosis10- elevation of temperature

localized(over mass) or generalized11-redness12-Scratch marks13-sign of hormonal disturbance as acne,

hirsutism14- Courvoisier's sign15-everted umbilicus

DIAGNOSIS CONT.3- investigation:

A-lab 1- full blood count

2-renal function test 3-liver function test 4-Bone marrow biopsy and/or

aspiration 5-GUE 6- other tests: uric acid, and lactate

dehydrogenase

DIAGNOSIS CONT.homovanillic acid ,vanillylmandelic &

metanephrine Serum B chorionic gonadotropin and

alpha-fetoproteinB-radiology

1- Ultrasound:Useful for discerning between solid versus

cystic mass

DIAGNOSIS CONT.2-Plain abdominal x-ray: Plain abdominalradiograph can be useful for detecting

obstruction by looking for the presence of

multiple air fluid levels or absence of air in the rectum. also may indicate the presence neuroblastoma, teratomas, Calcification, kidney stones, or,hydronephrosis

DIAGNOSIS CONT.3-CT scan: used to obtain more specific

anatomical detail especially with massess how are difficult to be visualized by x-ray as metastasis

DIAGNOSIS CONT.4-MRI: useful for soft tissue mass5-angiography: such as

a- invasive catheter angiography

b-CTA C-MRA6-PET scan7-endoscopy, colonoscopy

TREATMENTDepending on the cause of the mass & may

range from conservative Rx to radical surgeryA-medical:1-analgesic2-anti-inflammatory3-antimicrobial4- hormonal therapy

TREATMENTB-surgery:1-aspiration and/or drainage as in case of

cystic mass2-removal of the mass3-removal of the mass and part of the

affected organ4-removal of the entire organ &may be

associated with removal of the draining lymph node as in malignant tumor.

TREATMENTC-chemotherapy &/or radiotherapy which are used either neoadjuvant to shrink the tumor before

surgeryOr adjuvant when there is risk of

recurence or when there is micrometastases

PRODUCED BY

Dr. Haider faroon

THANKS FOR LISTENING