abdominal mass
Post on 25-Jun-2015
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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
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