CAUSES :
1. SWELLINGS IN THE ABDOMINAL WALL :
- INFLAMMATORY MASS LIKE CELLULITIS , ABSCESS , BOIL ETC.
- HAEMATOMA DUE TO RUPTURE OF ABDOMINAL MUSCLE DUE TO VIOLENT COUGH OR DUE TO TEARING OF INFERIOR EPIGASTRIC ARTRY
- TUMORS LIKE LIPOMA , FIBROMA , NEUROFIBROMA , DESMOID TUMOR, FIBROSARCOMA , MELANOMA OR NEOPLASTIC DEPOSIT FROM SOME INTRA ABDOMINAL TUMOR
2. GENERALISED ABDOMINAL SWELLINGS
- FAT
- FLUID - DUE TO CHF , CIRRHOSIS LIVER , NEPHROTIC SYNDROME , CARCINOMATOSIS PERITONEI , TUBERCULAR PERITONITIS OR PSEDOMYXOMA PERITONEI DUE TO RUTURE OF PSEDOMUCINOUS CYSTADENOMA OF OVARY OR A MUCOCELE OF THE APPENDIX
- FLATUS - DUE TO INTESTINAL OBSTRUCTION, MEGACOLON , ADYNAMIC ILEUS , AC GASTRIC DILATATION
- FAECES DUE TO CHR CONSTIPATION
- FETUS
3. LOCAL INTRA ABDOMINAL SWELLINGS
A. DUE TO GENERAL CAUSES :
- ENCYSTED ASCITIS , TUBERCULAR PERITONITIS OR LYMPHADINITIS , HYDATID CYST , SUBPHRENIC ABSCESS
B. REGIONAL ABDOMINAL SWELLINGS :
1. RT HYPOCHONDRIC REGION :
OTHER CAUSES THAN ALREADY LISTED UNDER HEPATOMEGALY & GALL BLADDER ENLARGEMENT
- FIRM & ROUNDED SWELLING IN THE UPPER SEGMENT OF RT. RECTUS MUSCLE
- TUMORS IN CONNECTION WITH HEPATIC FLEXURE OF THE COLON , SCYBALOUS COLLECTION OF FAECES OR HEAD OF INTUSSUSCEPTION.
2. EPIGASTRIC REGION :
- LIVER CAUSES
- STOMACH, DILATED BY PYLORIC STENOSIS , TUMOR OR FOREIGN BODY ( HAIR BALL OR TRICHOBEZOAR ) , - PALPABLE COLON DUE TO OBSTRUCTION
- OMENTAL SWELLINGS DUE TO TUBERCULOSIS OR MALIGNANCY - SWELLING FROM PANCREAS ( CANCER , CHR PANCREATITIS & RARELY AC PANCREATITIS, PANCREATIC CYST )
- RETROPERITONEAL CYSTS ( FROM MESONEPHRIC DUCT , TERATOMATOUS , LYMPHANGIOMATOUS OR DERMOID )
- DUODENAL SWELLINGS ( RARE ) : INFLAMMATORY MASS DUE TO DUODENAL ULCER
- ENLARGED LYMPH NODES
3. LEFT HYPOCHONDRIAC REGION :
- ABNORMAL LOBE OR TUMOR IN THE LT. LOBE OF LIVER
- GASTRIC SWELLINGS OR OTHER ABNORMALITIES OF STOMACH
- VARIOUS CAUSES OF SPLEENIC ENLARGEMENT( UNDER SPLEENOMEGALY )
- TUMORS OF PANCREAS & COLON
4. RT. LUMBER REGION
- RIEDELS LOBE OF LIVER
- ASCENDING COLON - FAECAL MASS , COLITIS , ILIO-CAECAL TUBERCULOSIS , COHNS DISEASE , MALIGNANCY , ILEO-CAECAL OR ILEO-COLIC INTUSSUSCEPTION
- TUMORS IN CONNECTION WITH KIDNEY OR SUPRARENAL GLAND
5. UMBILICAL REGION :
- GROSSLY DILATED STOMACH
- LESIONS OF TRANSVERSE COLON
- OMENTAL TUMORS
- SWELLINGS FROM KIDNEYS , SUPRA-RENALS , PANCREAS , RETROPERITONEAL TISSUE , PARA-AORTIC NODES & MESENTERY MAY COME IN THIS AREA.
- PULSATING AORTA
6. LT. LUMBER REGION :
- SPLEEN , KIDNEY , SUPRA-RENAL & COLONIC MASSES
7. RT. ILIAC FOSSA
- APPENDICULAR MASS , PARACAECAL ABSCESS , PYOSALPINX , SUPPURATING RT. ILIAC NODES , PSOAS ABSCESS , CARCINOMA OF CAECUM , OVARIAN CYST OR TUMOR OR A PEDUNCULATED FIBROID UTERUS.
8. HYPOGASTRIC REGION :
- DISTENDED BLADDER , ABDOMINAL SWELLING ARISING FROM THE UTERUS , OVARIES , FALLOPIAN TUBES & UTERINE LIGAMENTS , TUMORS OF ILIAL CROHNS DISEASE & URACHAL CYST
9. LT. ILIAC FOSSA:
- PELVIC COLON( NORMAL OR ABNORMAL), PARACOLIC ABSCESS , DIVERTICULITIS
OTHER TESTS :
* ULTRA SOUND WHOLE ABDOMEN - CAN REVEAL GAS UNDER DOME OF DIAPHRAGM IN CASE OF PERFORATION , SECONDARIES IN ABDOMEN IN CASE OF CARCINOMA , PANCREATITIS , INTESTINAL OBSTRUCTION, ANY INTRA ABDOMINAL TUMOUR, INTUSSUSCEPTION, STRANGULATED EXTERNAL HERNIA , APPENDICULAR LUMP, GALL BLADDER PATHOLOGIES, LIVER PATHOLOGIES, SPLEENIC RUPTURE, RENAL PATHOLOGIES, ECTOPIC PREGNANCY, SALPINGITIS, FIBROID, TWISTED OR RUPTURED OVARIAN CYST, PERITONEAL FLUID ETC
* X-RAY ABDOMEN ERECT - GAS UNDER DOME OF DIAPHRAGM IN CASE OF PERFORATION. > 3 FLUID LEVELS IN CASE OF INTESTINAL OBSTRUCTION
* LDH & SERUM AMYLASE - HIGH IN PANCREATITIS
* COLONOSCOPY - LARGE BOWEL TUMOURS , INTUSSUSCEPTION
* URINE ROUTINE - PYONEPHROSIS , CALCULUS , PYELONEPHRITIS , TRAUMA.
CT SCAN ABDOMEN - CAN DISGNOSE TUMOURS , ANEURYSM , LIVER OR ALL ABDOMINAL PATHOLOGIES.
* LIVER FUNCTION TEST - ABNORMAL IN LIVER DISEASES
* STOOL ROUTINE - OVA / CYST , OCCULT BLOOD IN CASE OF G.I. BLEEDING