Disease's Signs - Abdominal Mass

In both cases, a palpable abdominal mass is a clinical sign important and usually signals an important disorder, sometimes major (life-threatening).

For example if the patient has a pulsating mass in the middle area of the abdomen and severe abdominal or back pain, it will suspect a aortic aneurysm.

In this case, the patient should quickly reach the nursing home of specialty, even by calling the emergency service. Medical care will proceed quickly to check the signs Vital. Because the patient may require interventions Emergency surgical, it will be deprived of the administration of food and liquids, until the completion of the examination.

Usually it is will make preparations for the administration of oxygen, for initiation of I.V. infusions for liquids and blood for any volemic additions. The tests will be obtained Routine preoperators and the patient will be prepared for angiography. Pressure is also frequently monitored blood, pulse rate, breathing rate and outflow of urine., watching the appearance of shock signs, such as tachycardia, hypotension, but also cold-looking skin "transparent", which can indicate massive blood loss.

Nevertheless example shown is with low incidence, usually mass abdominal, as a sign develops insidiously and in the vast majority of cases will represent an enlarged organ, a neoplasm, an abscess, a vascular defect or an intestinal mass (especially fecal).

In the case of first diagnosis (if aortic aneurysm is not suspected), distinguishing an abdominal mass from a normal structure requires a skilful palpation. Sometimes palpation should be repeated with the patient in a different position or by a secondary examiner to verify the initial findings. Palpation will be initial shallow, followed by deep palpation localizing any pain or area with suspicion.

The patient will be asked if that meal is painful. If it is it will customize whether the pain is constant or if it occurs only at palpation, if it is localized or has a tendency to sasu irradiation generalization. If the patient is the one who first noticed the meal abdominal, information will be requested on any change in size and/or location that has been observed by patient in time. Pay attention to the patient's position when locates a table because some of these poot be detected only with the patient in the supine position, while others only in the lying position on the side.

In the case of detection, as far as possible, the size of this mass shall be estimated abdominal in centimeters, it will determine the shape (round, ovoid, etc) including trying to describe the contour as smooth, rough, sharp, nodular, irregular shape, etc. It also it will also determine the consistency of this mass, if it is "like dough", soft, solid hard saau.

Information useful can be obtained with the help of percussion, a dry sound indicating a mass full of liquid, a tympanic sound describing a mass filled with air.

Step next would be to determine the mobility of the abdominal mass Discovered. Determination that can be seen with the respiratory rhythm either by the possibility of movement with the hand. This will discover if this table is mobile or is attached to a internal organ or abdominal wall.

In order to determine whether the adhesion is relative to the abdominal wall, it will ask the patient that, lying on his back, to stretch his head to maximum, pulling the shoulders to the maximum down, simultaneously with contracting maximal abdominal muscles. When the muscles are contracted, try to palpate the abdominal mass, and if it is felt means that it has adhesion to the abdominal wall, if it does not feel adhesion is internal (front give an organ, depending on the placement its).

In most of the cases here will be completed the physical exam but there are cases in which it is necessary to continue it by by means of pelvic, genital and rectal examinations.

Continues Pag. 24 - Medicall causes - Professional Guide to Signs and Symptoms

All from patient information can be obtained on the medical history of the latter, in particular as regards the effects gastrointestinal with symptoms such as constipation, diarrhea, rectal bleeding, abnormally colored stools and vomiting. If the patient is female, information will be obtained on to the regularity of the menstrual cycle and when the first day of bleeding of the last menstrual cycle.

In the way obviously, the physical examination initiated will be completed. To come auscultation for intestinal noises on each quadrant in part. Will follow the exam of the skin to notice any possible scrapes, rubbing and/or enlarged blood vessels.

Bibliography:

1. Harrison – Treaty internal medicine (Principles of internal medicine), XIV edition, Teora Publishing House, 2010;

2. Kumar and Clark Medicine Internal - Adam Feather, David Randall, Mona Waterhouse, edition X, Hippocrates Publishing House, 2021.

3. Quick Evaluation, Guide diagram for the evaluation of signs and symptoms, Lippincott Williams & Wilkins, 2004.

4. Professional guide of signs and symptoms, V edition,Lippincott Williams & Wilkins, 2007.

5. Symptom Guide common, V Edition, McGraw - Hill, 2002.