Left upper quadrant cystic mass with tenderness

Introduction The cystic inflammatory mass of the left upper abdomen has obvious tenderness, such as a tumor, a cyst or an intragastric stone that is often a stomach or pancreas.

Cause

Common causes of abdominal mass:

(1) pathological enlargement of parenchymal organs: liver, spleen, kidney, pancreas and lymph nodes due to various reasons;

(2) expansion of the hollow organ;

(3) inflammatory masses;

(4) benign and malignant tumors;

(5) Parasites.

an examination

Related inspection

Abdominal vascular ultrasound examination of gastric ultrasound

1. Gastric cancer: more common in male patients with middle-aged or older, the clinical manifestations are weight loss, upper abdominal pain, discomfort, upper gastrointestinal bleeding, etc. When there is an abdominal mass, the multiple lesions are late, and the mass is mostly located in the upper abdomen or above the umbilicus. The texture is hard, the surface is irregular, the boundary is unclear, and the pyloric obstruction can be complicated in the late stage. Diagnosis can be made by X-ray barium meal or gastroscopy in parallel with biopsy.

2. Pancreatic pseudocyst: more secondary to pancreatitis or pancreatic trauma. Abdominal masses are mostly located in the middle and upper abdomen, varying in size, round or oval, and the surface is smooth; if the pseudocyst is compressed in the lower part of the common bile duct, there may be persistent or slow-deep jaundice; B-ultrasound, CT and other examinations can be found in the pancreatic sac Sexual mass.

Differential diagnosis

The left upper abdominal cystic mass has a differential diagnosis of tenderness:

1, abdomen "gas-like" mass: abdominal "gas-like" mass is a symptom of colon cancer. Colon cancer is more common in middle-aged and elderly people, and the majority of men aged 30-69 are more than women. Early symptoms are not obvious. Symptoms of common symptoms in the middle and late stage include abdominal pain and gastrointestinal irritation, abdominal mass, bowel habits and fecal trait changes, symptoms caused by anemia and chronic toxin absorption, and intestinal perforation.

2, the abdomen can touch a huge soft mass: the giant bladder - small colon - intestinal peristalsis syndrome patients are still normal weight at birth, later abdominal distension, no meconium, the abdomen can touch a huge soft mass, often susceptible to urinary Is an infection.

3, lower abdomen mass: lower abdomen mass refers to the lower abdomen has a lump, touch has a hard feeling, may be benign or malignant tumor, mostly for gynecological disease symptoms or intestinal, peritoneal diseases.

4, the right lower abdomen can touch the soft sausage-like mass: cecal granuloma with cecal amoebic granuloma and schistosomiasis granuloma. The cecal amoebic granuloma is a complication of chronic colitis caused by Entamaeba Histolytica. The ileocecal schistosomiasis granuloma is a late stage disease of intestinal schistosomiasis. The schistosomiasis egg deposition site is mainly the terminal ileum except the colon. The clinical symptoms are localized abdominal pain and intermittent diarrhea. The right lower abdomen can be touched with soft sausage-like mass. In addition, chronic low intestinal obstruction is often accompanied by acute intestinal obstruction.

5, the midline of the abdomen at the midline: the mass at the midline of the abdomen is a clinical feature of the white line. The bilateral rectus abdominis sheaths are interwoven in the midline of the abdomen to form a belly white line. The abdominal visceral vaginal white line is called the hernia of white line.

6, the abdominal wall outside the mass, there is fixed tenderness: the outer wall of the abdominal wall, fixed tenderness is the main clinical signs of the semilunar hernia. The anterior and posterior layers of the rectus abdominis sheath heal at the lateral edge of the rectus abdominis, forming a semi-moon-shaped, convex-laterally curved, sacral structure, ie the meniscus. The peritoneal or intra-abdominal organs protrude through the meniscus of the lateral abdominis, called the spigelian hernia, also known as the lateral abdomen. Spige (1617) first described the anatomy of the meniscus, so it is also known as spiglian.

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