This document discusses the fundamentals and generalities of clinically diagnosing an abdominal mass. It explains that an abdominal mass can be identified through palpation of the abdomen or suspected based on symptoms of obstruction, bleeding, or jaundice. The location of a palpable mass provides clues to its possible origin, while characteristics of the mass and associated symptoms help determine whether it is cancerous or not. Case illustrations demonstrate how symptoms can indicate the organ source of a non-palpable mass based on location cues. An abdominal mass may originate from the abdominal wall, peritoneum, or solid organs in the abdominal cavity.
CAD CAM DENTURES IN PROSTHODONTICS : Dental advancements
ROJoson PEP Talk: Abdominal Mass - Management - Fundamentals and Generalities
1. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL MASS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of
ABDOMINAL
MASS
[OVERVIEW]
April 9, 2022
1400H - 1500H
Via Zoom
2. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL MASS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of
ABDOMINAL
MASS
[OVERVIEW]
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.
3. There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.
4. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.
5. Contents of ABDOMINAL DISORDERS
[OVERVIEW]
• What is an abdominal disorder?
• What are the different types of abdominal
disorders?
• What are the causes of abdominal disorders?
• How common are the abdominal disorders?
• Clinical diagnosis of abdominal disorders?
• Paraclinical diagnostic procedures for
abdominal disorders?
• Basic treatment modalities for abdominal
disorders?
Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
March 19, 2022
1400H - 1500H
Via Zoom
• Abdominal Pain
• Abdominal Mass
• Abdominal Obstruction
• Abdominal Bleeding
• Jaundice
6. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL MASS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of
ABDOMINAL
MASS
[OVERVIEW]
My PEP TALK today
is entitled:
Fundamentals and
Generalities in
Medical
Management of
ABDOMINAL MASS
[AN OVERVIEW].
This is part of the
Health Disorder
Course.
7. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
Definition of Terms in Title AND Delimitation of
Coverage of Talk:
Fundamentals – simplest and essential facts and
theories which can serve as a basis or foundation
and support for advanced information
Generalities – general statements of info, not
covering specifics and details
Medical Management – diagnosis and treatment
by physicians
8. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
Contents of PEP TALK on ABDOMINAL
MASS
• What is an abdominal mass?
• What are the different types of abdominal
mass?
• What are the causes of abdominal mass?
• How common are the abdominal mass?
• Clinical diagnosis of abdominal mass?
• Paraclinical diagnostic procedures for
abdominal mass?
• Basic treatment modalities for abdominal
mass?
10. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• What is an abdominal MASS?
MASS is an unusual collection of tissues occupying
a space in any area or part of the human body.
ABDOMINAL MASS is an unusual collection of
tissues occupying a space in the belly.
It can be in the abdominal wall; peritoneal lining
of the abdominal cavity; or in any organ inside the
cavity.
Other terminologies:
BUKOL SA TIYAN
MASS OR TUMOR OR LUMP IN THE BELLY
11. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• What is an abdominal MASS?
BUKOL SA TIYAN
MASS OR TUMOR OR LUMP IN THE BELLY
• It may be of any size or shape.
• It may be of any consistency.
• It may be cystic, solid or complex.
• By itself, it can be of any etiology, either cancer
or not cancer, until determined by further
assessment.
13. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
Essentially, the different types will be based on
the origin of the MASS:
• abdominal wall
• lining of the abdominal cavity or
peritoneum
• solid organs*
• hollow organs* inside the abdominal
cavity
*with names of specific organs.
• What are the different types of abdominal
MASS?
15. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• What are the different causes of abdominal
MASS?
TRAUMA
• Hematomas
NON-TRAUMA
• Cancers
• Non-cancers
• Benign tumors
• Cysts
• Congenital abnormalities
• Degenerative tumors
• Infections (abscesses)
GENERAL CAUSES
16. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• What are the different causes of abdominal
MASS?
NON-TRAUMA CAUSES
• Cancers
• Non-cancers
• Benign tumors
• Cysts
• Congenital abnormalities
• Degenerative tumors
• Infections (abscesses)
Specific causes:
• Genetic predisposition
• Environmental factors –
foods, alcohol, smoking,
hygiene, atmosphere,
etc.
20. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Starting point in evaluation: patient has
unpleasant sensation in the abdomen or
pain. No history of trauma.
LOOK and PALPATE the abdomen!
Possible findings:
• NO palpable mass but with suspicion
for possible abdominal mass
• POSITIVE palpable mass
21. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Scenario 1:
• NO palpable mass but with suspicion for
possible abdominal mass
What are the symptoms that will make one
suspect a non-palpable abdominal mass as the
cause of the abdominal discomfort?
• If there are symptoms of abdominal
obstruction.
• If there are symptoms of abdominal bleeding.
• If there is jaundice.
Symptom cues for
gastrointestinal
obstruction –
vomiting, abdominal
distention, no
passage of stools per
anus
Symptom cues for
gastrointestinal
bleeding – vomiting
of blood; blood per
anus; black stools
An ABDOMINAL MASS could be present!
22. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Scenario 1:
• NO palpable mass but with suspicion for
possible abdominal mass
What are the symptoms that will make one
suspect a non-palpable abdominal mass as the
cause of the abdominal discomfort?
• If there are symptoms of abdominal
obstruction.
• If there are symptoms of abdominal bleeding.
• If there is jaundice.
May have to do a
paraclinical
diagnostic
procedure!
An ABDOMINAL MASS could be present!
23. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Scenario 2:
• POSITIVE palpable mass
• Determine the location of the palpable mass
on the abdomen. Use LOCATION to suspect the
possible origin of the mass.
24. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
• Determine the
location of the
palpable mass on
the abdomen.
Use LOCATION to
suspect the
possible origin of
the mass.
25. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Scenario 2:
• POSITIVE palpable mass
• Palpate for the characteristics of the palpable
mass such as size, shape, consistency (hard or
not hard), nature (cystic or solid), mobility,
presence or absence of tenderness, etc. This
may give further clues as to specific origin of
the mass and its cause, whether cancer or not
cancer.
26. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Scenario 2:
• POSITIVE palpable mass
• Analyze any associated symptoms present like
vomiting, distention, no passage of stools,
bleeding and jaundice and see if they are
consistent with a MASS in a suspected organ
just based on location.
27. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Scenario 2:
• POSITIVE palpable mass
• Once the origin of the abdominal mass is
somehow clear, then use symptoms and signs
to determine the specific diagnosis in terms of
whether it is a cancer or not cancer. Determine
also if the mass is an abscess or not.
29. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Case Illustration:
A patient presenting with epigastric mass.
Based on location, possible common organs of
involvement: stomach, pancreas, liver, and
intestines (small and large).
If JAUNDICE is an
associated
symptom, a LIVER
mass should be
suspected.
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
30. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Case Illustration:
A patient presenting with epigastric mass.
Based on location, possible common organs of
involvement: stomach, pancreas, liver, and
intestines (small and large).
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
If NO JAUNDICE,
STOMACH and
LARGE INTESTINE
should be suspected
as the possible
source of mass.
31. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Case Illustration:
A patient presenting with epigastric mass.
Based on location, possible common organs of
involvement: stomach, pancreas, liver, and
intestines (small and large).
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
If there is vomiting
of fresh blood
and/or black stool,
STOMACH should be
suspected as the
possible source of
mass.
32. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Case Illustration:
A patient presenting with epigastric mass.
Based on location, possible common organs of
involvement: stomach, pancreas, liver, and
intestines (small and large).
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
If there is
constipation, LARGE
INTESTINE should be
suspected as the
possible source of
mass.
34. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
Case Illustration:
A patient presenting with right upper quadrant
pain.
Based on location, possible common organs of
involvement: liver, gallbladder, and intestines.
If JAUNDICE is an
associated
symptom, a mass in
the LIVER (most
common),
PANCREAS and
GALLBLADDER
should be suspected.
35. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
Case Illustration:
A patient presenting with right upper quadrant
pain.
Based on location, possible common organs of
involvement: liver, gallbladder, and intestines.
If NO JAUNDICE, a
mass in the LIVER
(most common),
PANCREAS and
GALLBLADDER
should still be
suspected (as it may
be the jaundice has
not set in.
36. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
Case Illustration:
A patient presenting with right upper quadrant
pain.
Based on location, possible common organs of
involvement: liver, gallbladder, and intestines.
If NO JAUNDICE and
there are intestinal
symptoms, then
MASS in the
intestines should be
suspected.
38. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
Case Illustration:
A patient presenting with right lower quadrant
pain.
Based on location, possible common organs of
involvement: appendix, intestines, ovary (female)
If there are
intestinal symptoms,
then MASS in the
intestines should be
suspected.
39. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
Case Illustration:
A patient presenting with right lower quadrant
pain.
Based on location, possible common organs of
involvement: appendix, intestines, ovary (female)
If there are
gynecological
symptoms, then
MASS in the
gynecologic organs
(such as uterus and
right ovary) should
be suspected.
41. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
Case Illustration:
A patient presenting with left lower quadrant
pain.
Based on location, possible common organs of
involvement: intestines, ovary (female)
If there are
intestinal symptoms,
then MASS in the
intestines should be
suspected.
42. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
ILLUSTRATIONS OF
USE OF CUES TO
ANALYZE FOR
ORIGIN OF MASS
Case Illustration:
A patient presenting with left lower quadrant
pain.
Based on location, possible common organs of
involvement: intestines, ovary (female)
If there are
gynecological
symptoms, then
MASS in the
gynecologic organs
(such as uterus and
left ovary) should be
suspected.
43. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
TIPS:
BASIC EVALUATION METHODS:
• HISTORY TAKING – TO GET SYMPTOMS
• PHYSICAL EXAMINATION – TO GET SIGNS
CLINICAL DIAGNOSIS
SYMPTOM-BASED
EVALUATION
SIGN-BASED
EVALUATION
CLINICAL DIAGNOSIS
45. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
TIPS:
BASIC EXAMINATION OF THE ABDOMEN for MASS
LOOK AND PALPATE
• LOOK for unusual bulge that may suggest
mass.
• LOOK for abdominal distention that may
suggest intestinal obstruction, mass or fluid.
• PALPATE for possible presence of mass.
• PALPATE for presence of tenderness (pain on
pressure) – if present, evaluate further.
46. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Processes used in clinical diagnosis of
abdominal MASS:
• Pattern recognition process means realization
that the patient’s presentation conforms to a
previously learned picture or pattern of
disease.
• Prevalence process means choice of a diagnosis
is based on the frequency of occurrence of the
disease in a certain locality, in a certain age and
sex group, and in the affected organ and
system.
BASIC PROCESSES
47. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
TIPS:
In looking for the SPECIFIC CAUSE of ABDOMINAL
MASS,
use PATTERN RECOGNITION of a particular
medical condition or disease and PREVALENCE
process in those with similar presentation of
symptoms and signs.
• Primary clinical diagnosis: Most probable
• Secondary clinical diagnosis: Second most
probable
48. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal MASS?
Aids in clinical diagnosis:
• Location of mass
• Other symptoms and signs of abdominal
disorders such as
• Abdominal obstruction
• Abdominal bleeding
• Jaundice
• Other symptoms and signs of specific organ
disease
50. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Paraclinical diagnostic procedures for
abdominal MASS?
Common instrumental and laboratory diagnostic
procedures for ABDOMINAL MASS:
• Imaging procedures (x-rays – plain / with
barium dye; ultrasound; CT scan; MRI; PET
scan; etc.)
• Endoscopy (upper - esophagogastroscopy /
lower – colonoscopy, sigmoidoscopy,
proctoscopy)
• Blood tests (CBC; liver function tests; tumor
markers; etc.)
51. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Paraclinical diagnostic procedures for
abdominal MASS?
The foremost indication for a paraclinical
diagnostic procedure can be stated this
way:
if you are not certain on the primary
clinical diagnosis and you need to be
certain or be more certain before
treatment, then go for a paraclinical
diagnostic procedure.
52. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Paraclinical diagnostic procedures for
abdominal MASS?
To decide on indication of the paraclinical
diagnostic procedure,
the physician uses two processes –
- degree of certainty on the primary
clinical diagnosis and
- comparison of the treatment plans for
the primary and secondary clinical
diagnoses.
As a rule, there is no need
for a paraclinical
diagnostic procedure if:
• you are quite
certain of your
primary clinical
diagnosis.
• treatment plans for
primary and
secondary
diagnoses are the
same.
53. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Paraclinical diagnostic procedures for
abdominal MASS?
Competencies required of physicians managing
abdominal MASS:
• Know the uses and indications of all known
instrumental and laboratory diagnostic
procedures for abdominal mass.
• Use as needed and indicated.
• Select the most cost-effective one using the
BRCA process.
• Know how to interpret the results.
54. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Paraclinical diagnostic procedures for
abdominal MASS?
BRCA Process in selecting diagnostic procedures
Procedures Benefit
(goal – to
be more
definite on
the
diagnosis)
Risk Cost Availability
Option1
Option2
Option3
56. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Basic treatment modalities for abdominal
MASS?
SPECIFIC DISEASE SURGICAL / POTENTIALLY SURGICAL / NON-SURGICAL
W
X
Y
Z
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
57. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Basic treatment modalities for abdominal
MASS?
Examples of OUTRIGHT SURGICAL ABDOMEN
• Mass causing complete intestinal obstruction
• Resectable cancers
• Resectable non-cancers causing symptoms
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
Surgical Treatment:
• Drainage of
infections
(abscesses)
• Removal (-ectomy
such as
gastrectomy and
pancreatectomy)
58. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Basic treatment modalities for abdominal
MASS?
Examples of POTENTIALLY SURGICAL ABDOMEN
• Asymptomatic polyps
• Asymptomatic chronic abscess
• Asymptomatic benign tumors
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
59. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Basic treatment modalities for abdominal
MASS?
Examples of OUTRIGHT NON-SURGICAL
ABDOMEN
• Degenerative disorders like cysts
• Hormonal changes
• Surgical – outright surgical
• Non-surgical – non-surgical at all times (no OPERATION)
• Potentially surgical – surgical only when needed
Non-Surgical Treatment:
• Medicines
• NO medicines (watchful waiting;
natural support management; etc.)
60. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
• Clinical diagnosis of abdominal pain?
• Basic treatment modalities for abdominal
MASS?
BRCA Process in selecting cost-effective treatment
modality.
61. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
Contents of PEP TALK on ABDOMINAL
MASS
• What is an abdominal mass?
• What are the different types of abdominal
mass?
• What are the causes of abdominal mass?
• How common are the abdominal mass?
• Clinical diagnosis of abdominal mass?
• Paraclinical diagnostic procedures for
abdominal mass?
• Basic treatment modalities for abdominal
mass?
Summary
Take Away
62. Fundamentals
and Generalities
in Medical
Management of
ABDOMINAL
MASS
Be always in touch with reliable medical
information on fundamentals and
generalities in medical management of
ABDOMINAL MASS.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
medical management of ABDOMINAL
MASS.
Take Away in
relation to
Patient
Empowerment
63. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the MEDICAL
MANAGEMENT of
ABDOMINAL MASS.
Health Disorder
Course–
Fundamentals
and
Generalities in
Medical
Management
of
ABDOMINAL
MASS
[OVERVIEW]
Editor's Notes
March 19, 2022, I gave an overview of abdominal disorders. They 5 major types of abdominal disorders are abdominal pain; abdominal mass; abdominal obstruction; bleeding; and jaundice. In a subsequent PEPTalk, I already discussed abdominal pain. I shall now discuss Abdominal Mass.