Study of Profile of Large Abdominal Lumps in Surgery
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 8
Abstract
Abstract:Lump abdomen has always been a challenge to surgeons. Literatures mainly mention large abdominal lumps in gynaecological conditions as of ovary and uterus. This study was done to see the profile of large abdominal lump of 10 cm or more in size presenting in surgical wards. 1.To study clinical presentation, diagnosis & management of large abdominal lumps 10cm or more in size. 2.Morbidity and mortality related to large abdominal lumps.This Hospital based observational study was conducted in the year 2012-2013 in upgraded department of general surgery SMS Hospital, Jaipur. A descriptive study for all patients with abdominal lump size 10cm or more on USG,regarding their clinical presentation, diagnosis, treatment, histopathology and complication was designed.In this study of 70 patients, majority of them were female patients (80%). 44.3% cases were presented in 20 to 40 years of age group. Majority of cases in this study were admitted with complaint of pain (89%). 58.5% patients were having 10 to 15 cm size lump (according to USG finding). Most of the large abdominal lump were of ovarian origin (35.7%). Serum CA 125 Level was performed in 27 patients and out of these, 40.74% showed CA 125 Level >35 U/ml. Sensitivity of U.S.G in detecting the nature of lump was 61.4% and sensitivity of CT scan was 92.06%. Surgery was required in 77.14% of patients. Histopathological examination revealed 51.8% patients had malignant and 37.03% had benign pathology, 7.4% and 3.7% patients had inflammatory and tubercular pathology respectively. 27.1% patients developed complication in post operative period including wound infection(10%), pneumonitis(7.1%), wound dehiscence(2.9%) and urinary retention (2.9%). 4.3% patients were expired.In this study most of the large abdominal lumps were ovarian in origin (35.7%). Serum CA 125 level proved to be diagnostic in suspected cases of ovarian carcinoma. U.S.G was most helpful in diagnosing lumps originating from uterus and ovary. It was also helpful in cases of hydatid cyst liver, pseudopancreatic cyst and cases of splenic enlargement. CT scan proved to be most useful in evaluation of retroperitoneal lesion and tumours related to gut. Overall it was diagnostic in 92.06% of large abdominal lump.FNAC proved to be diagnostic in 82% of cases in which it was carried out. Keywords:Abdominal Lump, Computed Tomography Scan (CT scan), Fine Needle Aspiration Cytology (FNAC), Magnetic Resonance Imaging (MRI), Ultra Sonography (U.S.G)
Authors and Affiliations
Sudarshan Gothwal, Farukh Khan, Manila Nainawat
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