Abdominal swelling DDx

Abdominal swelling – Differential Diagnosis

Common causes

• Constipation
• Irritable bowel syndrome
• Pregnancy
• Fibroid uterus
• Distended bladder
• Hepatomegaly
• Splenomegaly
• Polycystic Kidney disease

Must Not Miss

• Ascites
  • Cirrhosis
  • Malignancy
  • CCF
  • Nephrotic syndrome
  • Other causes
• Intestinal obstruction
• AAA
• Malignancy
  • Colorectal cancer
  • Gastric Cancer
  • Renal carcinoma
  • Pancreatic Cancer
  • Lymphoma
  • Metastases (Liver)
  • Ovarian cancer
• Intra-abdominal Abscess

Easily missed

• Ovarian cancer/ cysts
• Diverticular disease

Red flags

• Severe abdominal pain
• Weight loss
• Persistent altered bowel habit: age > 50 years
• Persistent vomiting
• Jaundice
• Systemic features (fever, night sweats, anorexia)
• Abdominal mass
• Urinary retention
• Anaemia

Investigations to consider

• FBC, CRP/ESR
• U+Es, LFTs, Bone profile, Serum glucose
• Pregnancy test
• Tumour markers (CA125, CEA)
• Urinalysis/MSU
• AXR
• USS (Abdo & Pelvis)
• Ascitic tap
• Barium enema/ Colonoscopy
• CT

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