Intra-abdominal masses PDF
Preview Intra-abdominal masses
ABDOMINAL MASS Prof. Dr. Turgut IPEK A Palpable abdominal mass must be presumed to be due to serious abdominal disease unless the doctor is certain that the mass is a normal abdominal viscus. PALPABLE ABDOMINAL MASS Normal In abdominal wall At umbilicus Intra-abdominal Normal Bladder Right (left) kidney Aorta Intestine with gas and liquid Faeces Pregnant uterus Neonatal liver Normal abdominal masses The normal bladder becomes palpable in everyone if it is sufficiently distended by retained urine. The lower pole of the right kidney is sometimes, of the left kidney rarely, palpable. In a thin person with left kidney rarely, palpable. In a thin person with ill-developed musculature, the abdominal aorta is palpable in the epigastrium. Status of the liver Every abdominal surgeon knows from the experience of laparotomy that, in the patient lying supine, the liver projects well below the costal margin in the vast majority of patients, so that this projection in itself is unlikely to be the cause of the palpability of the normal liver. Site Most palpable abdominal swellings can be classified according to their site into one of the following categories: hernial orifices including the umbilicus, right upper quadrant, left upper quadrant, mid-line epigastric, right lower puadrant, left lower quadrant and suprapubic. Abdominal wall or intra-abdominal? When the patient contracts his abdominal muscles, an intra-abdominal swelling becomes less prominent or disappears while a mass in the abdominal wall becomes firmer and more obvious. Movement with respiratory excursions The part of the organ connecting the mass with the under-surface of the diaphragm must be rigid enough to transmit the thrust, and that the mass will move with ventilation if it is in indirect contact with the diaphragm via another interposed organ which is rigid enough to transmit the thrust.
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