Abdominal mass

Definition

A mass in the abdomen.

Epidemiology

More seen in the older generation, or people with scary conditions. Not the same thing as obesity, although can be harder to identify on examination in big bellies.

Clinical and Associated Features

The majority are asymptomatic, discovered on examination.

Symptoms can include pain or change in bowel habit. Obviously there are a wide variety of causes, which can have other symptoms, but also fairly common are weight loss, blood in stool, jaundice or bowel obstruction.

Differential Diagnosis

There are a lot of potential causes:

• Bowel issues - bowel cancer, inflammatory bowel disease, constipation.
• Hepatomegaly - hepatitis, cirrhosis, alcohol abuse, heart failure.
• Splenomegaly - haematological cancer, heart failure, haemolysis.
• Kidney problems - polycystic kidney disease.
• Enlarged bladder - hydronephrosis, bladder carcinoma
• Aortic aneurism or aortic dissection - is it pulsating? (This may be an emergency!)
• Uterine/ovarian masses - pregnancy, fibroids, cysts, ovarian cancer.
• Abdominal wall hernias - commonly either inguinal, femoral, umbilical or incisional

Investigations

1. Get history done to screen for family or personal family history of cancer.
2. Next do a good lump examination.
3. Now do a full blood count, urea and electrolytes, liver function tests, and clotting studies.
4. CT abdomen wouldn't hurt either.