ABDOMINAL MASSES

BY
DR YUSUF M

 May be pathological or nonpathological.

Benign or malignant.

Non-Pathological
It is better to first establish this
before carrying out investigative
studies.
Feaces due to constipation.
Pregnancy.
Full bladder suprabubic mass.
liver.
Arthero-sclerotic aorta.

Pathological

Hepatoma
Splenomegally.
Renal cell carcinoma.
Ovarian cyst
Colonic cancer

Location
Anatomical location gives an idea of
what the mass is.
Right hypochondral region.
Epigastric region.
Left hypochonrial region.
Left and right lumbar region.
Supra pubic.

RIGHT UPPER QUADRANT

Liver.
Gallbladder.
Right kidney.
Hepatic flexure of colon.
Stomach and duedenum.
Retroperitoneal structures.

EPIGASTRIUM

Stomach.
Left lobe of the liver.
Antrum of the stomach.
Duodenum.

LEFT UPPER QUADRANT

Spleen.
Stomach.
Splenic flexure.
Left kidney.

 Left iliac fossa- Sigmoid colon, ovary

Suprapubic region- Bladder mass,
uterus
Right iliac fossa- Appendix, caecum,
ovary, ascending colon.

AGE
Neonates- Congenital
malformations(wilms tumor or
nephroblastoma).
Young adults- inflammatory process
Middle aged and elderlyInflammatory, degenerative or
cancers.

GENDER
Elderly women- ovarian cancer or
uterine cancer.
Colonic cancers in both sexes
Aneurysms of abdominal aorta.

Geographical location
North America Cholelithiasis(Gall
bladder disease)
Asia or Africa- liver disease(Infective
or neoplastic).

Impaired function
A colonic mass will obstruct the
bowel
Cancer of the head of the pancreas
Jaundice
Intususseption- Obstruction
Antral mass- vomiting.

Mode of onset
Rate of enlargement of the mass is
important.
Suddenly mechanical
component,obstruction, hemorrhage.
Takes several days- inflammatory.
Insidious- Degeneration , chronic and
inflammatory.

Characteristics of the mass

Mobility.
Located on an organ.
Has not spread to adjacent
structures.
Change in position with respiration.
Enduration- Soft firm, hard, boggy.
Tenderness.

INVESTIGATION

Abdominopelvic USS.
Abdominal x-ray.
Abdominal CT.
Magnetic resonance imaging.
Intravenous urography.
Gastroscopy.
Colonoscopy.