ABDOMINAL MASS/LUMP

Abdominal masses in children may arise from any visceral organ; best identified according to their location (Table 14.9) as well as associated complaints.

Local examination of mass for location, size, surface, consistency, tenderness, ballotability (renal masses) along with per rectal examination in pelvic masses, often limits the diagnostic possibilities.

Although the choice of investigations depends on probable cause, ultrasonography is a baseline investi­gations in most cases, apart from urine and stool examination. CT/MRI and radionucleotide scan may be required in selected cases.

Right hypochondrium (hepatobiliary)

Hepatomegaly

Liver abscesses and cysts

Liver tumors (primary/secondaries)

Choledochal cysts, hydrops

Left hypochondrium (splenic)

Splenomegaly/cysts

Renal masses (see below- Lumbar mass)

Mid-abdominal (peri-umbilical)

Infantile hypertrophic pyloric stenosis

Intestinal—volvulus, intussusception, duplication Mesenteric—cysts, lymphadenoapthy Pancreatic—pseudopancreatic cysts

Lumbar (renal)

Congenital anomalies, e.g. polycystic kidney

Hydronephrosis

Renal vein thrombosis

Wilms' tumor

Suprapubic

Full bladder

Uterine mass, e.g. hydrometrocolposis

Sacroccygeal teratoma

Iliac region

Fecoliths

Appendicular abscess (Rt side)

Ovarian tumors or cyst

Pelvic inflammatory diseases

14.5