Abdominal masses

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 02/04/2015

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125 Abdominal masses

Patient 1

Instruction

Examine this patient’s abdomen.

Salient features

Examination

There is an epigastric mass.

Diagnosis

Differential diagnosis:

• Carcinoma of the stomach: look for supraclavicular lymph nodes, hepatomegaly; comment on pallor and asthenia

• Carcinoma of the pancreas: look for jaundice

• Aneurysm of the abdominal aorta: look for pulsatile mass, check femoral and foot pulses, auscultate over the mass and the femoral pulses (p. 455)

• Retroperitoneal lymphadenopathy (lymphoma).

Patient 2

Instruction

Examine this patient’s abdomen.

Salient features

Examination

There is a mass in the right iliac fossa.

Diagnosis

Differential diagnosis:

• Crohn’s disease: look for mouth ulcers; tell the examiner that you would like to look for fistulae and take a history for chronic diarrhoea (p. 778)

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