If you want to know about hard masses in the abdomen
If you want to know what the diagnosis of hard lumps in the abdomen can be.
If you want to know if hard abdominal masses can be a nuisance.
We recommend that you read on. In this article, we intend to answer all your questions about abdominal masses.
Abdominal masses may be inside the abdominal cavity, inside the pelvis, or in the abdominal wall, or in the space behind the peritoneum.
What are abdominal masses?
Generalized size, for example:
- Accumulation of fluid in the abdomen or ascites
- Pregnancy of a dead or living fetus in the womb
- Abdominal distention followed by gas accumulation and bloating and fecal accumulation
- Abdominal mass when there is a local mass touch
Abdominal masses can be benign or malignant or cystic. These masses, which may be localized in the abdomen, include cysts, abscesses, hernias, abdominal wall hematomas, or hematomas behind the peritoneum as well as dilated bladder.
It is noteworthy that there are very different differential diagnoses for rigid abdominal masses and differential diagnoses are determined based on the patient’s gender and age and the anatomical location of that abdominal mass.
Differential diagnoses of hard abdominal masses and more generally abdominal masses based on age are such that in infants one should think of congenital diseases, in children one should think of kidney tumors called Wilms tumor and neuroblastoma, and in young people one should think of inflammatory causes and Infectious causes and cancers in middle-aged and elderly people.
Common symptoms of abdominal masses
The most common clinical manifestations of abdominal masses are as follows:
- stomach ache
- Existence of visible mass
- Changes in defecation habits
- Recent weight loss that is inexplicable
- Existence of new urinary symptoms
- Excretion of blood in the urine
- And the feeling of fullness and early satiety
Differential diagnosis of abdominal masses based on where they are located
Differential diagnosis of masses in the epigastrium:
- Gastric cancer, Lymphoma gastric tumor or pancreatic cysts
- Obstruction of the gastric outlet
- In adults GOO
- In children with HPS
- Enlargement of the liver or hepatomegaly and aneurysm of the abdominal aortic artery
Abdominal mass in the right upper quadrant of the abdomen:
- Liver congestion
- Liver tumor
- Liver abscess
- Gallbladder tumors
- Lower rib abscesses
- Abscesses around the kidneys
- And abdominal wall hematomas
These are the things we mentioned in the upper right quadrant of the abdomen (along with tenderness)
Differential diagnosis of abdominal masses in the upper right quadrant of the abdomen:
The following differential diagnoses are for abdominal masses in the upper right quadrant of the abdomen but with no sensitivity to touch:
- Tumors such as cholangiocarcinoma
- Adrenal masses
- Kidney mass
- pancreas head cancer
- Gallbladder hydrops
- Liver metastases
- And fecal impaction
Abdominal mass in the lower right quadrant:
differential diagnoses of Abdominal mass in the lower right quadrant, if accompanied by tenderness, are as follows:
- Appendicitis abscesses
- Right ovarian and fallopian tube abscesses
- And intestinal intussusception
If the mass is insensitive to touch, tumors on the right side of the colon or appendix or right ovarian tumor are present.
Differential diagnosis of abdominal masses in the left and upper quadrants:
- Large spleen and splenomegaly
- Abscesses or cysts of the spleen
- Abdominal wall hematomas
- Gastric tumor
- Pancreatic tumor
- Colon tumors
- Kidney tumor
- Left adrenal tumor
- And spleen metastases
Differential diagnosis of abdominal masses in the lower left quadrant of the abdomen:
- Inflammation of the diverticulum
- Sigmoid tumors
- Tumors or ovarian cysts
- Abscesses and masses of the ovary and left fallopian tube
Differential diagnosis of abdominal mass in the hypogastric are:
- Uterine fibroids
- Uterine tumors
- And bladder tumor
The first step in achieving a correct diagnosis of hard abdominal masses is to get an accurate and complete history.
The lump may be asymptomatic, or there may be symptoms. If there are symptoms, doctors should know the presence, severity and course of the symptoms.
Are there any acute symptoms or are there any chronic or progressive symptoms?
Abdominal throbbing mass and acute and unbearable and progressive pain should be treated urgently.
- History of consumption of OCP
- Vaginal bleeding
- Last menstrual period
As well the characteristics of their menstrual cycles should be asked.
Problems such as heart palpitations, sweating and headaches should also be asked to rule out adrenal tumors.
History of previous surgeries, the presence or absence of cancer, previous chemotherapy and radiation treatments, family history of illnesses and medications, as well as habits such as smoking, alcohol and drug use, etc. should be asked.
After obtaining a complete history, the physician will proceed to a physical examination in accordance with the findings.
The first step is to examine the individual’s symptoms and condition in general, such as hypotension and palpitations.
The location of the tumor should be examined for shape, color changes, and so on.
Percussion and touching are used to evaluate the characteristics of the mass.
If the percussion is vague, fluid mass and accumulation may be present. If it is tympanic, the accumulation of gas may have increased and dilated the intestines, for example, following the obstruction of the lower part of the intestine, the gas may have accumulated in the upper parts.
In cases where there is fluid accumulation, such as abdominal ascites, doctors use a term called shifting dullness.
In the examination, the location, shape and size of the mass, as well as the characteristics of the mass surface, whether the mass is sticky or loose, whether the mass is moving around, and whether it is sensitive to touch or not, should be examined.
Intestinal sounds should also be heard by Stethoscope. Another point is the abdominal hearing in terms of the sound of blood flow.
If the diagnosis is unclear or we suspect, the doctor will use diagnostic aids to diagnose. He may request special tests or go for the following imaging techniques:
- abdomen imaging in standing position
- abdomen imaging in lying position
- Chest imaging
- CT Scan
- And MRI
A plain X-ray of the abdomen can be somewhat helpful in diagnosing faecalis, viewing aneurysms and aortas, as well as glass-like gallbladders, and somewhat viewing urinary stones and dilated stomach and intestines.
Ultrasound is used to diagnose anatomical location, and determine the size of the cystic mass, the solidity of the abdominal mass, as well as to some extent to examine the invasion to the surroundings and to make biopsy possible.
Depending on the circumstances, it may be used with injectable and oral contrast and is one of the best measures that doctors use to diagnose abdominal masses. Abdominal CT scans can detect the mass to some extent, determine adhesions to surrounding tissues and surrounding arteries, and also determine whether the mass is surgical or non-surgical.
- Abdominal MRI:
In some cases, kidney problems may be present, such as in nephropathy or pregnancy. In a pregnant woman with an abdominal mass, it is advisable to examine the pelvic masses and tumors of the colorectal area.
- CT angiography and MRI biography:
Vascular mapping of abdominal and pelvic masses before surgery.
Other diagnostic aids include endoscopic and colonoscopic PET scans.
If the diagnosis is determined by the measures mentioned above, the appropriate treatment will be performed according to the diagnosis. If the diagnosis is still not specified or is suspected, ultrasound and biopsy must be performed.
If the biopsy fails to make a complete diagnosis, they should enter the abdomen and pelvis with laparoscopy and receive a cytological biopsy. If all of the above are not diagnosed, the abdomen must be opened and a biopsy should be performed.
Treatment of abdominal masses depends entirely on what the type of mass is and where it originates. In the following, we refer to a number of these masses and state that each of them has a special treatment.
Abdominal masses of liver origin are:
- Simple abscesses and cysts
- Liver hydatid cyst
- Hepatic haemangiomas
- hepatocellular carcinoma tumor
- And liver metastases
Abdominal masses of gallbladder and bile duct origin:
- Gallbladder cancers
- Inflammation of the gallbladder
- Gallbladder hydrops
- Cysts and cholangiocarcinoma
Abdominal masses of splenic origin:
Abdominal masses of vascular origin:
- Abdominal aortic aneurysm
- Aneurysm of visceral vessels in the abdomen
- And iliac artery aneurysms
Retro-peritoneal or back peritoneal masses:
- Peritoneal fibrosis
- Hematomas following blows, accidents and coagulation disorders
Abdominal masses in women:
- Types of ovarian cysts
- Ovarian tumors
- Uterine tumors
- uterus cancer
- Uterine fibroids
- Ovarian abscesses
- Uterine tube abscess
- And ectopic pregnancy
Other causes of abdominal masses include diverticulum abscesses and tumors and cancers of the large intestine, small bowel tumors, cysts and tumors covering the lining of the intestine, intestinal torsion, kidney cysts, and kidney tumors. Adrenal tumors can also cause abdominal mass. As we said, the treatment of abdominal mass depends on the cause of the mass. Here are some treatment options:
Treatment can be supportive and conservative, for example, your doctor may give you painkillers and anti-inflammatory drugs or hormone therapy.
Treatment can be surgery, for example, a mass that is cystic and has a discharge can be aspirated or the discharge can be removed altogether.
The mass may be completely removed and the surrounding tissues may be removed with the mass in this surgery.
When should we see a doctor?
In the following cases, an emergency visit should be done immediately:
The first case: if the abdominal mass is pulsating.
The second case: if the symptoms are acute and very severe and are progressive in severity and there is severe abdominal pain.