Abdominal mass resident survival guide: Difference between revisions
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==Do's== | ==Do's== | ||
* | *Start the assessment of a [[patient]] with an [[abdominal mass]] using the pneumonic "ABC:" '''a'''irway, '''b'''reathing and '''c'''irculation, to identify an unstable [[patient]]. | ||
*Taking careful [[history]], and thorough [[physical examination]] are crucial to creating narrow differential diagnoses. | |||
*Among females of childbearing age (average age 12 and 51 or start of [[menstrual cycle]] till [[menopause]]), [[Pregnancy test|pregnancy screening]] (usually a [[Pregnancy test#Pregnancy test kit|urine pregnancy test]]) should be performed before diagnostic [[radiation]] exposure or interventions such as [[fluoroscopy]]‐guided interventions.<ref name="pmid28894775">{{cite journal |vauthors=Abushouk AI, Sanei Taheri M, Pooransari P, Mirbaha S, Rouhipour A, Baratloo A |title=Pregnancy Screening before Diagnostic Radiography in Emergency Department; an Educational Review |journal=Emerg (Tehran) |volume=5 |issue=1 |pages=e60 |date=2017 |pmid=28894775 |pmc=5585830 |doi= |url=}}</ref><ref name="pmid31788280">{{cite journal |vauthors=Gungor S, Celebi E |title=Detection of unrecognized pregnancy prior to a fluoroscopy-guided interventional procedure: A case report |journal=Clin Case Rep |volume=7 |issue=11 |pages=2207–2211 |date=November 2019 |pmid=31788280 |pmc=6878093 |doi=10.1002/ccr3.2437 |url=}}</ref> | |||
*Order an [[ultrasound]] or [[MRI]] among [[pregnant]] females to avoid exposure to [[radiation]]. | |||
*Perform a pelvic and [[testicular examination]] among patients with lower [[abdominal pain]]. | |||
*Correlate the [[CD4|CD4 count]] in [[HIV]] positive [[patients]] with the most commonly occurring [[pathology]]. | |||
*[[Abdominal aortic aneurysm]] and [[malignancy]] are more important considerations among [[patients]] above 50 years of age than for younger patients. | |||
*Suspect [[abdominal aortic aneurysm|ruptured abdominal aortic aneurysm]] in old patients presenting with a pulsating mass, associated [[abdominal pain]] and a history of tobacco use.<ref name="www.ncbi.nlm.nih.gov">{{Cite web | last = | first = | title = Diagnosis and management of 528 abdom... [Br Med J (Clin Res Ed). 1981] - PubMed - NCBI | url = http://www.ncbi.nlm.nih.gov/pubmed/6788329 | publisher = | date = | accessdate = }}</ref> | |||
==Don'ts== | ==Don'ts== | ||
Revision as of 13:44, 13 August 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: , Javaria Anwer M.D.[2]
Synonyms and keywords: abdominal lump resident survival guide
Overview
An abdominal mass is a vast entity in oncology.
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated. The life-threatening causes of an abdominal mass include:
- Abdominal aortic aneurysm, specifically ruptured abdominal aortic aneurysm. Total mortality is estimated to be 80–90 %. The 2013 mortality rate of US population above 44 years of age was 2.5 per 100,000. The incidence is on the decrease for the past two decades after a plateau. (the mortality rates act as a surrogate of incidence).[1]
- Volvulus
Common Causes
Common causes of an abdominal mass described below follow a descending order. The list is based on a retrospective study from Turkey among 45 adult patients who underwent surgery because of an intra-abdominal mass (between May 2010 and May 2017).[2]
Benign pathologies
- Mesenteric cyst
- Endometriosis
- Hydatid cyst
- Fibroma
- Dystrophic calcification
- Aberrant pancreas
- Leiomyoma
- Pseudocyst
Malignant pathologies
- Gastrointestinal stromal tumor (GIST)
- Liposarcoma
- Ovarian tumor
- Chondrosarcoma
- Neuroendocrine tumor
- Malignt mesenchymal tumor
- Lymphoma
- Schwannoma
Diagnosis
Shown below is an algorithm summarizing the diagnosis of abdominal mass according the the [...] guidelines.
Treatment
Shown below is an algorithm summarizing the treatment of abdominal mass according the the [...] guidelines.
Do's
- Start the assessment of a patient with an abdominal mass using the pneumonic "ABC:" airway, breathing and circulation, to identify an unstable patient.
- Taking careful history, and thorough physical examination are crucial to creating narrow differential diagnoses.
- Among females of childbearing age (average age 12 and 51 or start of menstrual cycle till menopause), pregnancy screening (usually a urine pregnancy test) should be performed before diagnostic radiation exposure or interventions such as fluoroscopy‐guided interventions.[3][4]
- Order an ultrasound or MRI among pregnant females to avoid exposure to radiation.
- Perform a pelvic and testicular examination among patients with lower abdominal pain.
- Correlate the CD4 count in HIV positive patients with the most commonly occurring pathology.
- Abdominal aortic aneurysm and malignancy are more important considerations among patients above 50 years of age than for younger patients.
- Suspect ruptured abdominal aortic aneurysm in old patients presenting with a pulsating mass, associated abdominal pain and a history of tobacco use.[5]
Don'ts
- The content in this section is in bullet points.
References
- ↑ Starnes, Benjamin (2017). Ruptured abdominal aortic aneurysm : the definitive manual. Cham: Springer. ISBN 978-3-319-23844-9.
- ↑ "cms.galenos.com.tr" (PDF).
- ↑ Abushouk AI, Sanei Taheri M, Pooransari P, Mirbaha S, Rouhipour A, Baratloo A (2017). "Pregnancy Screening before Diagnostic Radiography in Emergency Department; an Educational Review". Emerg (Tehran). 5 (1): e60. PMC 5585830. PMID 28894775.
- ↑ Gungor S, Celebi E (November 2019). "Detection of unrecognized pregnancy prior to a fluoroscopy-guided interventional procedure: A case report". Clin Case Rep. 7 (11): 2207–2211. doi:10.1002/ccr3.2437. PMC 6878093 Check
|pmc=value (help). PMID 31788280. - ↑ "Diagnosis and management of 528 abdom... [Br Med J (Clin Res Ed). 1981] - PubMed - NCBI".