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Appendicitis

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...

Assessment of the Abdomen III: Palpation

Assessment of the Abdomen III: Palpation

Palpation is a crucial tactile examination method for assessing abdominal organs and detecting conditions like tenderness, distention, masses, or fluid. It involves both light and deep palpation techniques, each serving specific diagnostic purposes. Light palpation helps identify tenderness and other surface-level indicators, while deep palpation locates and assess abdominal masses and organ boundaries. A skilled professional can gather valuable insights through palpation, including evaluating...

Assessment of the Rectum and Anus

Assessment of the Rectum and Anus

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...

Assessment of the Abdomen I: Inspection and Auscultation

Assessment of the Abdomen I: Inspection and Auscultation

Introduction
The abdominal examination is a cornerstone of clinical medicine, serving as a critical tool in diagnosing various gastrointestinal (GI) diseases. It involves a systematic approach that includes inspection and auscultation, each with distinct yet complementary roles in assessing the abdomen. This article will delve into these two primary methods healthcare professionals use to examine the abdomen.
Inspection of the Abdomen
The first step in any abdominal examination is inspection.

Appendicitis-I: Introduction

Appendicitis-I: Introduction

The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...

Appendicitis-II: Diagnostic Studies and Management

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...

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Updated: Jun 22, 2026

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy

Published on: March 10, 2023

Abdominal lump: a diagnostic dilemma.

R S Bhandari¹, M Shrestha, G K Shrestha

¹Department of surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. rameshbhandari2000@yahoo.co.in

JNMA; Journal of the Nepal Medical Association

|June 17, 2009

Summary

This case highlights a diagnostic dilemma where initial investigations suggested a liver hydatid cyst, but surgery revealed a giant hydronephrosis. This underscores the challenges in diagnosing abdominal lumps.

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Last Updated: Jun 22, 2026

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy

Published on: March 10, 2023

Area of Science:

Abdominal imaging
Surgical diagnosis
Differential diagnosis of abdominal masses

Background:

Abdominal lumps can present diagnostic challenges, sometimes deviating from typical presentations despite thorough investigation.
Routine clinical examinations and imaging (ultrasound, CT scan) are standard for evaluating abdominal masses.

Observation:

A 21-year-old male presented with a three-year history of a gradually increasing right upper abdominal lump.
Initial investigations (USG, CT scan) led to a diagnosis of a liver hydatid cyst.

Findings:

Laparotomy revealed the mass to be a right-sided giant hydronephrosis with nonviable renal tissue, not a liver hydatid cyst.
The patient underwent a successful right nephrectomy with good postoperative recovery.

Implications:

This case emphasizes the potential for significant discrepancies between imaging diagnoses and surgical findings in abdominal masses.
It highlights the importance of considering rare presentations and the limitations of diagnostic imaging in complex abdominal lump cases.
Such diagnostic dilemmas necessitate a high index of suspicion and preparedness for unexpected findings during surgical exploration.