gradually distended abdomen
Introduction
Introduction The gradual enlargement of the abdomen means that the abdomen gradually expands over a period of time. This symptom can be caused by a variety of reasons, and the most common and typical cause is pregnancy. Abdominal swelling caused by pregnancy is a normal condition. It is a false pregnancy that needs to be identified. The worse case may be a primary tumor. Secondary tumors are often found during surgical exploration of other organ lesions or at the same time as advanced recurrent tumors. The prominent feature is that the abdomen is swollen, and most patients have abdominal pain and bloating.
Cause
Cause
The cause is not clear, women with normal pregnancy, pseudo pregnancy, cirrhosis, omental tumors, etc. can cause this symptom.
Examine
an examination
Related inspection
Abdominal auscultation, abdominal shape, palpation, abdominal percussion, abdominal plain, abdominal perspective
Symptoms and signs
Secondary tumors are often found during surgical exploration of other organ lesions or at the same time as advanced recurrent tumors. The prominent feature is that the abdomen is swollen, and most patients have abdominal pain and bloating.
Abdominal pain
When the tumor is large, most patients have symptoms such as abdominal pain, fullness, and dysfunction of the digestive tract. 65% of patients may have abdominal pain, increased pain when lying on their back, reduced standing, and a few cases of nausea.
2. Abdominal mass
Abdominal percussion can touch the mass. The primary tumor is characterized by a gradual enlargement of the abdomen. The abdominal mass can be found in the physical examination.
3. Ascites
Malignant tumors may have ascites in the late stage, may have bloody or non-blood ascites, and have percussive dullness.
4. Weight loss
Patients with malignant tumors have obvious systemic symptoms and weight loss, which may be associated with systemic wasting, anemia or cachexia.
The diagnosis of retinal tumors is difficult, and most cases are diagnosed because of abdominal masses for exploration or because of tumors found in the omentum during abdominal surgery.
Clinical examination
Clinical manifestation
Abdominal pain aggravated when lying on the back; abdominal mass with weight loss; a lot of ascites can have mobile dullness.
2. Laboratory and auxiliary inspection
A CT scan can assist with the diagnosis.
3. Histopathological examination
The nature and type of the tumor can be determined. No specificity. Blood routine examination may have anemia, and ascites test is mostly bloody exudate. A histopathological examination should be performed.
4. Imaging examination
(1) X-ray examination
It is often used to determine the location of the omental mass. If the plain film of the abdomen shows a shadow of the tumor in front of the abdominal cavity or a gastrointestinal barium meal examination, it is found that there is a tumor in front of the intestine and it is not related to the intestine.
(2) B-mode ultrasound examination
It has a preliminary judgment on the omental inflammatory mass, cyst or tumor. It helps to determine the location of the tumor, and its nature is cystic or solid.
(3) CT examination
CT scan can display a variety of images, mass, massive omentum, small nodular invasiveness, cystic mass or multiple isolated nodules, is the best means to determine the large omentum mass, it can not only determine The location of the tumor and its relationship with the surrounding tissues and organs also have a good diagnostic value for the greater omental torsion and vascular infarction.
(4) Laparoscopy
Combined with biopsy can identify the cause and nature of the lesion.
Diagnosis
Differential diagnosis
Differential diagnosis of abdominal swelling:
First, false pregnancy
1, nausea, vomiting: colds or stomach upset and other moods, diseases will also lead to this feeling, so this situation is difficult to judge whether it is pregnant.
2, menstrual stop: women who usually have this symptom, the menstrual cycle is not regular, plus psychological factors affect the regulation of hormones, may not last for several months, menstruation will not come, and because of this, when menstruation When often, it is often mistaken for abortion.
3, conscious fetal movement: This feeling is actually only a strong production creep. When the stomach is uncomfortable, nausea, vomiting, and obvious peristalsis are very common phenomena, but because the symptoms are too similar to those in the early stages of pregnancy, they are often confused by women who are eager to get pregnant.
4. Abdominal uplift: Most women who are usually pregnant with pregnancies will eat too much nutritious food at the beginning, in this case. Within a short period of time, the lower abdomen will continue to stand out and be mistaken for pregnancy. If the uterus grows a lot of uterine fibroids or is relatively obese, it can cause significant abdominal bulging.
Second, the primary tumor
1. Omental tumors: Tumors of the omentum can be divided into primary and secondary types. Omental tumors are mostly metastatic tumors, and the primary site is often in the colon, stomach, pancreas or ovary. Primary retinal tumors are rare and have benign and malignant points. Benign tumors include malignant tumors such as lipoma, leiomyoma, hemangioma and neurofibromatosis, such as leiomyosarcoma, rhabdomyosarcoma, vascular epithelioma, fibrosarcoma and myxomas. Malignancy accounts for about 1/3.
2, retroperitoneal tumor: primary retroperitoneal tumor refers to the tumor occurring in the retroperitoneal space, retroperitoneal tumor mainly from the retroperitoneal space of fat, loose connective tissue, muscle, fascia, blood vessels, nerves, lymphoid tissue, etc. Tumors of various organs (kidney, pancreas, adrenal gland, and ureter, etc.) that were originally in the retroperitoneal space were not included. It is a rare tumor. Most of them are malignant, accounting for about 70%. Benign tumors are more common with teratomas, schwannomas, and fibroids. Malignant tumors are mainly composed of liposarcoma, fibrosarcoma, leiomyosarcoma, embryonic carcinoma, neurofibrosarcoma, and malignant lymphoma.
3, ovarian cysts: ovarian cysts are a kind of ovarian tumors in a broad sense, can be sick of all ages, but women with 20-50 years old are the most common. Ovarian tumors are common tumors of female genitalia and have various properties and forms, namely: single or mixed type, one side or two sides, cystic or substantial, benign or malignant, of which cystic is more common. The degree of malignant transformation is very high. Early diagnosis is difficult, 70% of the patients are in advanced stage, rarely get early treatment, and the 5-year survival rate is always 20-30%, which is one of the most serious malignant tumors that threaten women's lives.
5, peritoneal mesothelioma: peritoneal mesothelioma (peritoneal mesothelioma) is a primary tumor of the peritoneal epithelium and mesothelial tissue, clinically rare. Pathologically, it can be divided into adenomatoid mesothelioma, cystic mesothelioma and peritoneal malignant mesothelioma (PMM). The former two are benign tumors.
6, peritoneal pseudomyxoma: peritoneal pseudomyxoma is a clinically rare disease characterized by a large number of mucous gelatinous substances dispersed in the peritoneal peritoneum or omentum surface.
Third, secondary tumors
Secondary tumors are often found during surgical exploration of other organ lesions or at the same time as advanced recurrent tumors. The prominent feature is that the abdomen is swollen, and most patients have abdominal pain and bloating.
