Abdominal mass
(Redirected from Epigastric mass)
Jump to navigation
Jump to search
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
- Get history done to screen for family or personal family history of cancer.
- Next do a good lump examination.
- Now do a full blood count, urea and electrolytes, liver function tests, and clotting studies.
- CT abdomen wouldn't hurt either.