approach to the abdominal mass

2. An 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.

3. Many 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

4. 2-Change in appetite
3- frequency, dysuria ,polyuria
4-Changes bowel habit
5-Rapid weight loss or weight gain
6- fever,sweating
7-nausea, vomiting
8- fullness
9-hematuria
10-appearance of mass

5. Serious symptoms that might indicate
a life-threatening condition
1-Abdominal mass that is growing
rapidly
2-Abdominal mass that is pulsating
3-New abdominal mass accompanied
by severe abdominal pain

7. 1-Ascites
2-Gastrointestinal perforation and sepsis
3-Incontinence
4-Infertility due to permanent damage to the
reproductive tract
5-Permanent kidney damage
6-Permanent liver damage
7-Permanent pancreas damage
8-Ruptured aortic aneurysm
9-Secondary obstruction of the small and large
intestine
10-metastasis in case of CA
11-Spread of infection

9. Medications That May Cause
Lymphadenopathy
Allopurinol
Atenolol
Captopril
Carbamazepine
Cephalosporins
Gold
Hydralazine

10. 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.

11. 4-important sign:
1-tenderness
2-yellowish discoloration of skin& sclera
3-anemia
4-raccon eye
5-oedema
6-lymphadenopathy
7-localized or generalized enlargment of
abdomen

12. 8-dullness on percussion
9-ecchymosis
10- elevation of temperature localized(over
mass) or generalized
11-redness
12-Scratch marks
13-sign of hormonal disturbance as acne,
hirsutism
14- Courvoisier's sign
15-everted umbilicus

14. 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

15. homovanillic acid ,vanillylmandelic &
metanephrine
Serum B chorionic gonadotropin and alpha-
fetoprotein
B-radiology
1- Ultrasound:
Useful for discerning between solid versus
cystic mass

17. 2-Plain abdominal x-ray: Plain abdominal
radiograph 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

19. 3-CT scan: used to obtain more specific
anatomical detail especially with massess
how are difficult to be visualized by x-ray as
metastasis

20. 4-MRI: useful for soft tissue mass
5-angiography: such as
a- invasive catheter angiography
b-CTA
C-MRA
6-PET scan
7-endoscopy, colonoscopy

22. Depending on the cause of the mass & may range
from conservative Rx to radical surgery
A-medical:
1-analgesic
2-anti-inflammatory
3-antimicrobial
4- hormonal therapy

23. B-surgery:
1-aspiration and/or drainage as in case of
cystic mass
2-removal of the mass
3-removal of the mass and part of the affected
organ
4-removal of the entire organ &may be
associated with removal of the draining
lymph node as in malignant tumor.

24. C-chemotherapy &/or radiotherapy
which are used either
neoadjuvant to shrink the tumor before
surgery
Or adjuvant when there is risk of recurence or
when there is micrometastases

25. Dr. Haider faroon