CLINICAL DIAGNOSTIC MANUAL
An abdominal mass in the hypogastrium, or suprapubic area, is a clinical manifestation that can result from various pathologies. It is characterised by the presence of a palpable lump or swelling in the lower abdomen, above the pubic bone. Identifying and evaluating a mass in this area is crucial, as it may be related to structures within the urinary, reproductive, or digestive systems, with causes ranging from benign conditions to malignancies.
Pathology | Symptoms and Clinical Signs | Suspicion Diagnosis | Confirmatory Diagnosis |
Interstitial Cystitis | Chronic pelvic pain, increased urinary urgency and frequency, pain during urination | Based on clinical history and recurrent symptoms of pelvic pain and urinary issues | Cystoscopy with hydrodistension and bladder biopsy to observe Hunner’s ulcers and inflammatory changes |
Uterine Fibroid | Heavy menstrual bleeding, pelvic pain, pressure on the bladder | Clinical suspicion based on symptoms and finding of a pelvic mass on examination | Pelvic ultrasound or MRI showing uterine masses consistent with fibroids |
Ectopic Pregnancy | Acute abdominal pain, vaginal bleeding, signs of shock in severe cases | Suspected in women of childbearing age with abdominal pain and positive pregnancy test | Transvaginal ultrasound showing absence of intrauterine pregnancy with adnexal mass and elevated hCG levels |
Bladder Cancer | Haematuria, pelvic pain, changes in urinary habits | Based on symptoms and finding of mass or irregularities in the bladder | Cystoscopy with biopsy and transurethral resection of the bladder to confirm the presence of cancerous cells |
Meckel’s Diverticulitis | Abdominal pain, gastrointestinal bleeding, signs of bowel obstruction | Suspected in patients with unexplained abdominal pain and bleeding | Technetium-99m scintigraphy to detect ectopic gastric tissue, confirmed by surgical resection |
Pelvic Abscess | Fever, severe pelvic pain, signs of local inflammation | Suspected in patients with fever, leucocytosis, and localised pelvic pain | Pelvic CT or MRI showing a fluid collection with abscess characteristics, confirmed by drainage and culture |
Ovarian Tumour | Abdominal pain, abdominal distension, urinary or gastrointestinal symptoms | Suspected based on physical examination and presence of a pelvic mass | Pelvic ultrasound, MRI, and eventually biopsy during surgery to confirm the nature of the tumour |
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