Pediatric emergency medicine trisk 3782 3782

Intra-abdominal masses may be benign or malignant. Children are often
asymptomatic even when the tumor is large; frequently, the mass is detected by
the caregiver noticing a protuberant or lopsided abdomen.
It is difficult to feel an intra-abdominal mass, as well as outline its limits and its
degree of mobility, if an infant or child is crying. After allowing the child to calm,
the physician should make an effort to palpate the intra-abdominal contents
carefully. These masses can be fragile and prone to rupture; therefore, palpation
of the mass should be done gently and strictly limited to as few examiners as
possible.
Retroperitoneal masses tend to be fixed, whereas masses attached to the
mesentery or omentum are mobile and may be shifted to different locations by the
examiner. Pelvic masses are commonly fixed and often can best be felt by rectal
examination. A presacral mass may narrow the rectum and produce constipation.
Abdominal masses present with various characteristics and may be smooth,
nodular, cystic, or firm.