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Abdominal swellings are a common surgical problem. Abdominal swellings may be divided into generalised and localised swellings. Generalised swellings are classically described as the ‘five Fs’, namely fat, faeces, flatus, fluid or fetus. For the purpose of description of localised swellings, the abdomen can be divided into nine areas, i.e. right upper quadrant, left upper quadrant, epigastrium, umbilical, right lumbar, left lumbar, right iliac fossa, left iliac fossa and suprapubic area. Many of the swellings that occur in the different abdominal regions have similar aetiological causes and therefore have been described according to the organ affected. Hepatomegaly, splenomegaly and renal masses are dealt with under the relevant heading in other sections of the book.
Lipoma
Hernia (i.e. paraumbilical, umbilical, spigelian hernia)
Metastatic deposits (i.e. Sister Joseph Mary nodule)
Other (i.e. urachal cyst)
See hepatomegaly, p. 215.
Secondary to carcinoma of the head of the pancreas
Mucocele
Empyema
Carcinoma
Carcinoma
Gastric distension (acute dilatation, pyloric stenosis)
Acute gastric volvulus
Carcinoma
Pseudocyst
Hydronephrosis
Solitary cyst
Carcinoma
Polycystic kidney ( Fig. 2 )
Pyonephrosis/perinephric abscess
Tuberculosis (TB)
Wilms’ tumour (nephroblastoma)
See splenomegaly, p. 393.
Appendix abscess
Carcinoma (i.e. caecal mass)
Faeces
Diverticular mass
Volvulus (i.e. caecal, sigmoid)
Intussusception
Crohn’s disease
Carcinoma
Mesenteric cysts
Lymphoma
Ileo-caecal TB
Acute retention
Chronic retention
Carcinoma
Ovarian cyst
Ovarian neoplasm
Pregnancy
Ectopic pregnancy
Tubo-ovarian abscess
Uterine fibroid
Uterine carcinoma
Arterial aneurysm (i.e. aortic, iliac)
Lymphadenopathy (lymphoma, secondaries from testicular carcinoma)
Neoplasm of the iliac bone, e.g. osteogenic sarcoma, Ewing’s tumour
Omental secondaries, e.g. stomach and ovary
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