Tuesday, March 20, 2012

Abdominal swellings (localized): reduced abdominal


KEY POINTS
Retroperitoneal mass: zero movement having respiration, tricky to be able to delineate, resonant to help percussion.
Bowel masses: usually mobile, could possibly be well defined.
Pelvic mass: challenging for getting below', bimanually palpable on PR/PV
examination.
Sigmoid colon
Diverticular mass: tender, ill defined, rubbery hard, non-mobile.
Paracolic abscess: acutely tender, ill defined, ?fluctuant, systemic
upset.
Carcinoma: hard, craggy, non-tender unless perforated, immobile,
connected to changed bowel habit/obstructive symptoms.
Faeces: firm, indentable/malleable', cell phone having colon.
Normal: solely in a very tiny person, non-tender, chord like.
Caecum/ascending colon
Appendix mass/abscess: acutely tender, sick defined, fluctuant,
systemic upset.
Carcinoma: hard, craggy, non-tender unless perforate d, immobile,
related to anaemia/weight reduction and anergia.
Terminal ileum
Crohn's mass: tender, ill defined, rubbery hard, non-mobile.
Tuberculous mass: gently tender, ill defined, firm, associated along with cutaneous sinuses, systemic TB.
Ovary/fallopian tube Cyst: may be massive, typically mobile, ?bimanually palpable on PV examination.
Neoplasm.
Ectopic pregnancy: very tender, associated with PV bleeding/ intra-abdominal blood loss and also collapse.
Salpingo-oophoritis: pretty tender, bimanually palpable, connected to PV discharge.
Bladder
Generally: midline swelling, extends upward in direction of umbilicus, boring to be able to percussion, non-mobile, are unable to get below' it.
Retention associated with urine: stony unexciting to percussion, regarding need to pass urine, vanishes upon voiding/catheterization.
Transitional mobile phone carcinoma: hard, irregular, fixed, could be associated with dysuria, haematuria and want to pass urine with examination.
Uterus
Pregnancy: smooth, regular, fetal coronary heart appears heard/ movements!
Fibromyoma: generally smooth, could possibly be pedunculated and mobile, non-tender, associ ated menorrhagia.
Uterine carcinoma: firm uterus, may perhaps be tender, abnormal if only tumour can be extrauterine, involved PV bloody discharge.
Rectum
Carcinoma: firm, irregular, non-tender, rather immobile, linked amendment in intestinal habit/PR bleeding.
Urachus (rare)
Cyst: smaller puffiness with midline, ?associated umbilical discharge.
Other
Pelvic kidney: smooth, regular, non-tender, non-mobile.
KEY INVESTIGATIONS
FBC: anaemiabtumours.
WCC: lymphomas, Crohn's disease, appendicitis/diverticulitis.
LFTs: liver lesions.
Ultrasound: ovarian lesions, appendix/diverticular muscle size as well as abscess, Crohn's mass, pelvic kidney, ovarian lesions, pregnancy, uterine lesions, bladder tumours.
CT scan: retroperitoneal/mesenteric cysts, omental deposits, appendix/diverticular mass and also abscess, Crohn's mass. Allows guided drainage with abscesses and also biopsy regarding many tumours.
Colonoscopy: colonic tumours, diverticular disease.
Small bowel enema: tiny intestinal tract tumours, ileal Crohn's disease.
Barium enema: diverticular disease, colonic tumours.
MSU: afflicted urinary retention.
-HCG: pregnancy.

Source: Surgery At some sort of Glance


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