Abdominal Pain and Abdominal Mass

2020 ◽  
Author(s):  
Madison M. Crutcher ◽  
Darshak S. Thosani ◽  
Mohammad F. Shaikh ◽  
Wilbur B. Bowne
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Physical Examination ◽  
Acute Abdominal Pain ◽  
Abdominal Mass ◽  
Gastroesophageal Junction ◽  
Percutaneous Biopsy ◽  
Clinical History ◽  
Diagnostic Process ◽  
Abdominal Masses

Acute abdominal pain and abdominal mass are intimately connected; therefore, the diagnostic process for evaluating abdominal pain and abdominal masses is largely the same and has been preserved since ancient times. The primary goals in the management of patients with abdominal pain and/or abdominal mass are to establish a differential diagnosis by obtaining a clinical history, to refine the differential diagnosis with a physical examination and appropriate studies, and to determine the role of operative intervention in the treatment or refinement of the working diagnosis. This review describes the process of diagnosing abdominal pain, including taking a clinical history and performing a physical examination. Investigative studies, including laboratory tests, imaging, and pathology are reviewed. Management, including surgical treatment, is discussed. Tables describe intraperitoneal and extraperitoneal causes of acute abdominal pain, frequency of specific diagnoses in patients with acute abdominal pain, and common abdominal signs and findings noted on physical examination. Figures show abdominal pain in specific locations, a data sheet, the differential diagnosis of an abdominal mass by quadrant or region, characteristic patterns of abdominal pain, acute appendicitis with associated appendicolith, bilateral adrenal masses, adrenocortical carcinoma, retroperitoneal leiomyosarcoma, pancreatic mass, a sagittal ultrasonogram of the pancreas, ultrasonograms of the liver, a dark and well circumscribed abdominal mass, gastroesophageal junction adenocarcinoma, and percutaneous biopsy of a large abdominal mass. An algorithm outlines the assessment of acute abdominal pain and abdominal mass. This review contains 16 figures, 5 tables, and 164 references. Keywords:  anatomy, swellings, inflammatory, opioid, palpatation, PET, COVID 19

Abdominal Pain and Abdominal Mass

2018 ◽  
Author(s):  
Blake D. Babcock ◽  
Alexander E. Poor ◽  
Mohammad F. Shaikh ◽  
Wilbur B. Bowne
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Physical Examination ◽  
Acute Abdominal Pain ◽  
Abdominal Mass ◽  
Gastroesophageal Junction ◽  
Percutaneous Biopsy ◽  
Clinical History ◽  
Diagnostic Process ◽  
Abdominal Masses

Acute abdominal pain and abdominal mass are intimately connected; therefore, the diagnostic process for evaluating abdominal pain and abdominal masses is largely the same and has been preserved since ancient times. The primary goals in the management of patients with abdominal pain and/or abdominal mass are to establish a differential diagnosis by obtaining a clinical history, to refine the differential diagnosis with a physical examination and appropriate studies, and to determine the role of operative intervention in the treatment or refinement of the working diagnosis. This review describes the process of diagnosing abdominal pain, including taking a clinical history and performing a physical examination. Investigative studies, including laboratory tests, imaging, and pathology are reviewed. Management, including surgical treatment, is discussed. Tables describe intraperitoneal and extraperitoneal causes of acute abdominal pain, frequency of specific diagnoses in patients with acute abdominal pain, and common abdominal signs and findings noted on physical examination. Figures show abdominal pain in specific locations, a data sheet, the differential diagnosis of an abdominal mass by quadrant or region, characteristic patterns of abdominal pain, acute appendicitis with associated appendicolith, bilateral adrenal masses, adrenocortical carcinoma, retroperitoneal leiomyosarcoma, pancreatic mass, a sagittal ultrasonogram of the pancreas, ultrasonograms of the liver, a dark and well circumscribed abdominal mass, gastroesophageal junction adenocarcinoma, and percutaneous biopsy of a large abdominal mass. An algorithm outlines the assessment of acute abdominal pain and abdominal mass. This review contains 14 figures, 5 tables, and 143 references.

scholarly journals Neglected Appendicitis? One Patient Two Diagnosis? Differential Diagnosis of Acute Abdominal Pain

2020 ◽  
Author(s):  
Eunice Vieira e Monteiro ◽  
Cláudia Paiva ◽  
Paulo Soares
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Physical Examination ◽  
Female Patient ◽  
Laparoscopic Appendectomy ◽  
Acute Abdominal Pain ◽  
Computed Tomography Scan ◽  
Tomography Scan

Authors present a case report of a female patient, with 38-years-old, admitted with alithiasic acute pancreatitis.During the hospitalization on day 6 she referred migration of the pain to the lower right quadrant and had pain in decompression; she underwent a computed tomography scan that was compatible with acute appendicitis.She was admitted to the operating room and laparoscopic appendectomy was performed. Surgery and hospitalization were uneventful and she was discharged on the 10th day after admission.The purpose to present this case is related to need to draw doctors’ attention to do an accurate physical examination and a selective interpretation of diagnostic exams in order to make a correct differential diagnosis and guide treatment.

Midthoracic Punctate Midline Myelotomy for Treatment of Chronic, Intractable, Nonmalignant, Abdominal Visceral Pain: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (2) ◽  
pp. E183-E183 ◽  
Author(s):  
Tyler Ball ◽  
Zaid Aljuboori ◽  
Haring Nauta
Keyword(s):  
Abdominal Pain ◽  
Physical Examination ◽  
Surgical Procedure ◽  
Visceral Pain ◽  
Lower Abdominal Pain ◽  
Clinical History ◽  
Dorsal Column ◽  
Complete Relief ◽  
Patient Reported

Abstract Punctate midline myelotomy (PMM) is a surgical procedure that damages the ascending fibers of the postsynaptic dorsal column (PSDC) pathway to interrupt visceral pain transmission.1-3 It can offer relief to patients with chronic visceral pain conditions that are refractory to other treatments. Here, we present a surgical video of midthoracic PMM in a patient with chronic, intractable, nonmalignant visceral abdominal pain that failed over a decade of medical treatment. We choose T7-8 as the level for laminectomy in patients with pelvic or lower abdominal pain, because the postsynaptic pain fibers transmitting visceral pain sensation from the lower abdominal organs will invariably be caudal to this level. The patient developed immediate and complete relief of her visceral pain after the procedure, which was sustained through the 11-wk follow-up period to date and was able to be weaned off narcotics. Postoperatively, she remained full strength and had no impairment of light touch or proprioception of her lower extremities. Detailed physical examination showed a reduced vibratory sensation on the glabrous skin of her great toes. Regarding patient-reported sensory changes (not detected on physical examination), she reported some numbness on the insides of her feet that had resolved by 11-wk follow-up. She also reported some numbness of the vulva, but not of the vagina. However, by 11-wk follow-up, she reported this had resolved and she had normal sexual function. The only persistent sensation at 11-wk follow-up was slight tingling in her toes that was not bothersome to her.4 The patient presented in the following video consented to both the surgical procedure and the publication of her clinical history and operative video.

scholarly journals Abdominal Pain in the Female Patient: A Case of Concurrent Acute Appendicitis and Ruptured Endometrioma

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Martine A. Louis ◽  
Amanda R. Doubleday ◽  
Elizabeth Lin ◽  
Ji Yoon Baek ◽  
Alda Andoni ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdominal Pain ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Common Cause ◽  
Surgical Emergencies ◽  
Ovarian Endometrioma ◽  
General Surgeons

General surgeons are often asked to evaluate acute abdominal pain which has an expanded differential diagnosis in women of childbearing age. Acute appendicitis accounts for many surgical emergencies as a common cause of nongynecologic pelvic pain. In some rare instances, acute appendicitis has been shown to occur simultaneously with a variety of gynecologic diseases. We report a case of concurrent acute appendicitis and ruptured ovarian endometrioma.

Acute abdominal pain

2018 ◽  
Author(s):  
Satish Keshav ◽  
Alexandra Kent
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Clostridium Difficile ◽  
Diagnostic Tests ◽  
Secondary Care ◽  
Acute Abdominal Pain ◽  
Intestinal Ischaemia ◽  
Pelvic Brim

Acute abdominal pain is pain which is below the chest and above the pelvic brim and which has been present for ≤4 weeks. However, typically, patients present within hours of the onset of pain. The differential diagnosis does not differ much in primary and secondary care, although patients in hospital are probably more likely to be prone to iatrogenic illnesses such as pancreatitis, intestinal ischaemia, and Clostridium difficile-associated colitis. This chapter covers the approach to diagnosis, key diagnostic tests, therapies, prognosis, and dealing with uncertainty.

Cyriax syndrome: a misdiagnosed condition of the chest wall

2019 ◽  
Vol 27 (7) ◽  
pp. 609-611
Author(s):  
Sarra Zairi ◽  
Mariem Hadj Dahmane ◽  
Monia Attia ◽  
Amira Dridi ◽  
Taher Mestiri ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Young People ◽  
Physical Examination ◽  
Chest Wall ◽  
Rare Entity ◽  
Hypochondriac Region ◽  
The Right

Cyriax syndrome is a rare entity of the chest wall, which mainly affects young people. It can manifest as abdominal pain in the right or left hypochondriac region, which may be very intense, and often causes problems in the differential diagnosis. We report the case of a 36-year-old man who presented with intense left hypochondrial pain, worsening on exercise. After multiple specialized consultations and several unnecessary and expensive investigations, a diagnosis of Cyriax syndrome was obtained. A thorough physical examination might have been sufficient to evoke the diagnosis.

scholarly journals Cystic intra-abdominal masses in children

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Luisa Ferrero ◽  
Riccardo Guanà ◽  
Giulia Carbonaro ◽  
Maria Grazia Cortese ◽  
Luca Lonati ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Abdominal Distension ◽  
Abdominal Ultrasound ◽  
Mesenteric Cyst ◽  
Diagnostic Tools ◽  
Surgical Approaches ◽  
Radical Excision ◽  
Palpable Mass ◽  
Abdominal Masses

Benign intra-abdominal cystic masses in infancy are fairly uncommon and their etiopathogenesis, histology and clinical presentation differ significantly. Our aim is to report our experience in their treatment in order to discuss the best diagnostic and treatment modality. The medical records of 5 children (2M, 3F) with cystic intraabdominal masses referred to our hospital between November 2012 and September 2016, were retrospectively reviewed. All patients underwent open surgery and subsequent histopathologic analysis. Different clinical presentations, localizations of the masses, diagnostic tools, surgical approaches, histological examinations and outcomes were reviewed. Patients mean age was 5.4 years (range: 8 months-9 years). Two patients presented recurrent abdominal pain and abdominal distension; 1 patient had a palpable mass discovered incidentally and 2 complained acute abdominal pain. Routine laboratory tests, tumor markers and abdominal ultrasound were immediately done in all patients. Three patients underwent MRI and 1 abdominal CT. At laparotomy 2 hepatic cysts, 2 mesenteric cyst and 1 retroperitoneal cyst were discovered. Histology reports described: 1 hepatobiliary cystadenoma, 1 benign hepatic hamartoma and 3 cystic lymphangiomas (1 retroperitoneal and 2 mesenteric). There were no major postoperative complications, deaths, or recurrences in our series (follow-up 3-24 months). Despite the rarity of these lesions, benign cystic abdominal masses in children are not so uncommon and should be considered as causes of acute abdominal pain. The differential diagnosis is not always possible preoperatively. In our series, radical excision of the lesions was possible in all cases, allowing reliable histological results and avoiding recurrences.

scholarly journals Involucrin in the differential diagnosis between linear psoriasis and inflammatory linear verrucous epidermal nevus: a report of one case

2013 ◽  
Vol 88 (4) ◽  
pp. 604-607 ◽  
Author(s):  
Flávia Regina Ferreira ◽  
Nilton Gioia Di Chiacchio ◽  
Márcia Lanzoni de Alvarenga ◽  
Samuel Henrique Mandelbaum
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Clinical Manifestations ◽  
Clinical History ◽  
Epidermal Nevus ◽  
Linear Psoriasis

Inflammatory linear verrucous epidermal nevus is a variant of verrucous epidermal nevus, characterized by recurrent inflammatory phenomena. Despite well-established clinical manifestations, the differential diagnosis between inflammatory linear verrucous epidermal nevus and linear psoriasis remains difficult. Clinical history, physical examination and histopathology analysis may not be sufficient to confirm the diagnosis. We report the case of a 4-year-old girl in which the involucrin immunostaining was helpful in the diagnosis of inflammatory linear verrucous epidermal nevus. Our findings confirm that involucrin immunohistochemistry is a useful tool in such cases.

scholarly journals L’Ambulatorio protetto: visitare ai tempi del Covid-19

QUADERNI ACP ◽  
2021 ◽  
Vol 28 (4) ◽  
pp. 173
Author(s):  
Davide Ursi ◽  
Cristina Scozzafava ◽  
Sara Immacolata Orsini ◽  
Andrea Apicella
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Histological Analysis ◽  
Abdominal Mass ◽  
Sudden Onset ◽  
Lymphatic Malformation ◽  
Surgical Removal ◽  
Lymphatic Malformations ◽  
Cystic Structure ◽  
Abdominal Masses

A 3-months baby comes to our emergency department for an abdominal mass of elastic consistency that suddenly appeared for a week and grown exponentially in the last few days. Blood examinations identify a septic state of the child, and the emergency CT recognizes the abdominal mass’s cystic structure. The surgical removal and the histological analysis will confirm the diagnosis of Infected Common Macrocystic Lymphatic Malformation. This case allows us to remember to pediatricians the main features of Cystic Lymphatic Malformations that should always be considered during the differential diagnosis of abdominal masses of sudden onset in an infant.

Sign in / Sign up

Export Citation Format

Share Document