Abdominal masses

　　There are many causes of abdominal masses. The following will be introduced in detail for everyone:

　　First, the cause of the disease

　　1. Masses in the upper right abdomen

　　(1) Enlargement of the liver: such as hepatitis, liver abscess, liver tumors, and liver cysts, etc.

　　(2) Enlargement of the gallbladder: such as acute cholecystitis, gallbladder hydrops, gallbladder hemorrhage, cholestatic gallbladder enlargement, congenital choledochal cyst, primary gallbladder cancer, and gallbladder torsion, etc.

　　(3) Colon cancer at the hepatic flexure.

　　2. Masses in the upper middle abdomen

　　(1) Gastric masses: such as ulcer disease, gastric cancer, and other benign and malignant tumors in the stomach, gastric mucosal prolapse, and gastric stone disease, etc.

　　(2) Pancreatic masses: such as acute pancreatitis, pancreatic cysts, cystic adenomas of the pancreas, pancreatic cancer, etc.

　　(3) Enlargement of the left lobe of the liver.

　　(4) Mesentery and omentum masses: such as mesenteric lymphadenitis, mesenteric cysts, etc.

　　(5) Small intestine tumors: Such as small intestinal malignant lymphoma, small intestinal cancer, and other rare small intestinal tumors.

　　(6) Abdominal aortic aneurysm.

　　3, Left upper abdominal mass

　　(1) Splenic enlargement: Liver cirrhosis, wandering spleen, accessory spleen, etc.

　　(2) Pancreatic tumors and pancreatic cysts.

　　(3) Colorectal cancer of the splenic flexure.

　　4, Masses on both sides of the waist

　　(1) Masses caused by kidney diseases: Such as kidney ptosis and wandering kidney, congenital renal cysts, hydronephrosis, pyonephrosis, horseshoe kidney, renal hydatid cysts, kidney tumors, etc.

　　(2) Pheochromocytoma and other adrenal tumors.

　　(3) Primary retroperitoneal tumor.

　　5, Right lower abdominal mass

　　(1) Appendiceal diseases: Such as appendiceal abscess, appendiceal carcinoid, appendiceal mucinous cyst, etc.

　　(2) Mass at the ileocecal region: It is common in ileocecal tuberculosis, Crohn's disease, cecum cancer, ileocecal amebic granuloma, ileocecal actinomycosis, etc.

　　(3) Omental torsion.

　　(4) Right ovarian tumor.

　　6, Lower abdominal mass: It can be seen in bladder tumors, bladder diverticula, uterine tumors.

　　7, Left lower abdominal mass: It can be seen in ulcerative colitis, rectum, sigmoid colon cancer, rectum, sigmoid colon schistosomiasis granuloma, left ovarian cyst, etc.

　　8, Widespread and non-localized masses: Common causes include tuberculous peritonitis, abdominal form of pulmonaryStrongyloidiasis, abdominal hydatid cysts, peritoneal metastatic cancer, intussusception, parasitic intestinal obstruction, intussusception, etc.

　　Second, Pathogenesis

　　Although abdominal masses have many causes, their pathogenesis does not go beyond the following points.

　　1, Organ enlargement: Abdominal solid organs often become enlarged due to inflammation or hyperplasia of organ tumor tissue. Circulatory disorders, such as chronic congestive heart failure or constrictive pericarditis, can cause liver enlargement due to congestion. The kidneys can become enlarged due to ureteral obstruction, stenosis, or pressure, leading to poor drainage and hydronephrosis. Portal hypertension caused by various reasons can lead to splenic enlargement due to the obstruction of splenic venous blood flow. Enlargement can also be due to organ torsion or ectopic formation.

　　2, Distension of hollow organs: Hollow organs often become obstructed due to inflammation, masses, or organ torsion, causing fluid and gas to accumulate in the lumen, leading to organ distension. For example, during pyloric stenosis, the expansion of the stomach can be seen in the upper abdomen. Intestinal obstruction can be seen as a segmental shape in the upper segment. Lower urinary tract obstruction causes bladder urine retention, leading to bladder distension. Biliary obstruction causes bile excretion to be unsmooth, leading to gallbladder distension.

　　3, Abdominal inflammation: When abdominal organs or tissues are inflamed, inflammatory masses may appear if abscesses form, such as liver abscess, perinephric abscess, and appendiceal abscess. Abdominal inflammation can cause organs and tissues to adhere to each other, forming masses. The most common is tuberculous peritonitis.

　　4, Abdominal mass: Benign and malignant tumors of abdominal organs often form masses at the site due to abnormal proliferation of tissue, such as gastric cancer and pancreatic cancer often seen as masses in the upper abdomen. The mass compresses adjacent organs, such as pancreatic cancer compressing the common bile duct causing gallbladder enlargement. Benign abdominal masses are mostly cysts and can be congenital or secondary to inflammation. Generally, the growth rate is slow, but the size can be large.

　　Abdominal masses can present with different complications according to their source, nature, location, or different organs.

　　1. Inflammatory mass:Can lead to complications such as sepsis, abscesses, etc.

　　2. Tumor mass:Complications such as distant metastasis, cachexia, anemia, etc.

　　3. Cystic mass:Sometimes, complications such as hemorrhage, malignancy, secondary infection, and obstruction can occur in the cystic mass.

　　4. Obstructive mass:Complications such as jaundice, liver enlargement, and electrolyte imbalances.

　　The main method of examining abdominal masses is palpation. If a mass is found during palpation, attention should be paid to the location, size, shape, texture, tenderness, and mobility of the mass. This helps to distinguish the source and nature of the mass.

　　1. Location of abdominal mass:Determining the location of the mass can help understand the source of the mass. A mass in a certain location often originates from the organ in that location, such as a mass in the upper right abdomen often originates from the liver, gallbladder, or hepatic flexure of the colon. A pedunculated mass or mesenteric mass, a large omentum mass, or a large mass in the intestinal distribution area. If there is obstruction, the mass may be a tumor inside the segment of the intestine. If there is no obstruction, it is often derived from the mesentery, omentum, or retroperitoneal organs. Multiple and scattered masses are common in tuberculous mesenteric lymph nodes, peritoneal tuberculosis, or abdominal metastatic cancer.

　　2. Size of the mass:A small mass felt around the umbilicus may be an enlarged mesenteric lymph node. Large masses often occur in organs such as the liver, spleen, pancreas, kidney, ovary, and uterus, with cysts being common. If the size of the mass varies, it may even disappear, and it may be caused by gaseous loops of the intestines.

　　3. Shape of the mass:Smooth-surfaced masses are often cysts, with irregular shapes and rough surfaces, and are usually malignant tumors, inflammatory masses, or tuberculous masses.索状或管状肿物,短时间内形态多变者,可能为蛔虫团或肠套叠。A round mass that can be felt in the upper right abdomen is smooth and may be the gallbladder or kidney. An enlarged spleen can be felt with a splenic notch.

　　4. Hardness and texture of the mass:Hardness of the mass is often seen in tumors, inflammatory or tuberculous masses, such as gastric cancer, liver cancer, and masses formed by tuberculous peritonitis. If the mass is cystic, the mass is soft, and it is often seen in cysts.

　　5. Tenderness:Inflammatory masses have obvious tenderness, such as a mass in the lower right abdomen, which has obvious tenderness and is often an abscess around the appendix. A liver with obvious tenderness may be a liver abscess.

　　6. Degree of mobility:If the mass moves up and down with breathing, it may be a tumor of the liver, spleen, kidney, stomach, or these organs, or a tumor of the gallbladder or transverse colon, which can also move up and down with breathing. If the mass can be pushed by hand, it may come from the stomach, intestines, or mesentery. Masses with a wide range of movement and large distances are often pedunculated masses, such as wandering spleen, wandering kidney, etc. Tumors in the peritoneum and local inflammatory masses generally do not move.

　　The best way to prevent abdominal masses is early diagnosis and early treatment. Change bad living habits and cultivate a healthy lifestyle. Do not drink alcohol, smoke less. Prevent infection by vaccination with hepatitis B vaccine, HPV (human papillomavirus) vaccine, maintaining good hygiene to avoid multiple sexual partners, staying away from drugs. Choose healthy foods and beverages instead of high-fat, high-sugar, and high-calorie foods, eat more different types of vegetables and fruits, whole grains, and legumes, reduce the intake of red meat (beef, pork, and lamb), avoid eating processed meats, and limit the intake of high-salt foods.

　　Laboratory examination is of great significance for the diagnosis of abdominal masses. If the mass is significantly tender and the white blood cell count is elevated, the mass is mostly an inflammatory mass or a large spleen, accompanied by a significant increase in white blood cells to tens of thousands, and immature cells, indicating chronic myelocytic leukemia. Examination of the bone marrow can make a definite diagnosis. An upper abdominal mass, if the occult blood test is persistently positive, the mass may be gastric cancer. Liver enlargement is often accompanied by abnormal liver function, liver enlargement with increased alpha-fetoprotein indicating primary liver cancer. If accompanied by ascites, routine examination of ascites can differentiate between exudative fluid and transudative fluid. Liver enlargement with transudative ascites may be caused by liver cirrhosis or circulatory disorders leading to liver congestion. The white blood cell classification of ascites can differentiate between purulent infection and tuberculosis infection. Blood ascites often suggest malignant tumors. If cancer cells are found in the ascites, it indicates that the tumor has metastasized. Tissue biopsy of the mass can often make a clear determination of the nature of the mass.

　　To clarify the exact location and organ of the abdominal mass and its nature, it is necessary to choose appropriate instruments for examination in order to provide reliable evidence for the formulation of surgical treatment plans. Common examination methods include X-ray contrast, B-ultrasound, CT, magnetic resonance imaging, and endoscopy.

　　For the diagnosis of abdominal masses, radiographic contrast, B-ultrasound, CT, and magnetic resonance imaging are suitable for the examination of solid organs to understand the locative lesions within the organs, which is also an important means for diagnosing bladder and uterine masses. The best examination method for gastrointestinal masses is endoscopy, and laparoscopy can be used for abdominal masses. When performing endoscopic examination, it is necessary to take living tissue for histological examination to determine the nature of the mass. When choosing the above examination methods, it is advisable to choose methods that are both economical and accurate, and to avoid repeated examinations.

　　Patients with abdominal masses shouldEat more coarse grains and mixed grains, such as brown rice, corn, whole wheat flakes; eat less refined rice and flour; often eat nutritious dried fruit and seed foods such as sunflower seeds, sesame seeds, pumpkin seeds, watermelon seeds, peanuts, walnuts, dried apricots, almonds, raisins, etc. It should also. Maintain smooth defecation, you can use jellyfish, bitter melon, sweet potatoes, etc. You can also alleviate symptoms through diet:.

　　1, Goat's milk and rock sugar boiled eggs:250 grams of goat's milk, 50 grams of crushed rock sugar, 1-2 eggs. Dissolve the rock sugar in a little water, pour it into the goat's milk and bring it to a boil, then add the eggs and stir well. Boil until about to boil and it is ready to eat. It has the effects of replenishing the middle and warming the stomach, moistening dryness and nourishing blood. It is suitable for people with weakness of the spleen and stomach after surgery.

　　2, Longan pork bone stewed turtle:50 grams of longan meat, 250-500 grams of pork backbone with bone and marrow, 500 grams of turtle. Wash the longan meat, chop the pork bone into pieces, cut the turtle into pieces, add an appropriate amount of water, and simmer for a long time. Add salt and season for eating. It has the effects of invigorating the spleen and generating blood, nourishing the kidney and yin. It is suitable for people with body weakness after surgery.

　　3, Fructus lycii lean pork turtle soup:40 grams of fructus lycii, 150 grams of lean pork, 560 grams of softshell turtle. Wash the fructus lycii, cut the lean pork into thin slices, and remove the internal organs of the softshell turtle and cut it into pieces. Put the above foods in a pot, add an appropriate amount of water, and simmer until cooked. Sprinkle salt and season, and eat it. It has the effects of nourishing yin and blood, benefiting the liver and kidney. It is suitable for people with blood deficiency and weakness after surgery.

　　4, Lily and Panax notoginseng stewed rabbit meat:40 grams of lily, 15 grams of panax notoginseng, 250 grams of rabbit meat. Wash the lily, cut the panax notoginseng, cut the rabbit meat into thin slices, put it in a pot, add an appropriate amount of water, and simmer over low heat until cooked. Season and drink the soup or eat it as a side dish. It has the effects of clearing heat and detoxifying, nourishing yin and stomach.

　　An abdominal mass is a common clinical symptom and sign that can be caused by various diseases. Therefore, when encountering patients with abdominal masses in clinical practice, it is necessary to actively seek the primary disease that causes the mass. Only by treating the primary disease can the mass shrink or disappear. If the mass is determined to be caused by inflammation, it is called an inflammatory mass, such as appendiceal abscess, intra-abdominal tuberculous mass, enlarged lymph nodes, etc., and active anti-inflammatory treatment should be carried out. After anti-inflammatory treatment, if the patient's pain or tenderness decreases or disappears, and the mass shrinks or disappears, the diagnosis of inflammatory mass can generally be established; otherwise, mass caused by other reasons should be considered. In addition to inflammatory masses, generally speaking, for masses suspected to be tumor masses, if possible, fine needle aspiration of the mass should be performed and cytological examination should be conducted. Once diagnosed as a tumor, if there is an indication for surgical treatment, timely surgical treatment should be carried out. For solid abdominal masses caused by various diseases, if the diagnosis is basically clear, there are surgical indications, or the mass has caused intestinal obstruction, surgical treatment or exploration should be performed..