Download MBBS General Surgery PPT 12 Hypochondrial Lump Lecture Notes

APPROACH TO A PT OF RT

HYPOCHONDRIAL LUMP
HISTORY

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PHYSICAL EXAMINATION

INVESTIGATIONS

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PROCEDURE LIKE EXPLORATION

HISTOPATHOLOGY

HISTORY

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AGE
SEX
PAIN
VOMITINGS

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MOTIONS
URINATION
FEVER
PHYSICAL EXAMINATION

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GENERAL

SYSTEMIC

LOCAL

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GENERAL PHYSICAL EXAM

APPEARANCE

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EMACIATED

ANAEMIC

JAUNDICED

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LYMPH NODES
ABDOMINAL EXAMINATION

INSPECTION

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PALPATION

PERCUSSION

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AUSCULTATION

INSPECTION

ABDOMINAL DISTENTION

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VISIBLE PERISTALSIS
OVERLYING SKIN
POSITION,SIZE,SURFACE OF SWELLING
MOBILITY WITH RESPIRATION
HERNIA SITES

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SCROTUM
PALPATION

SOFT OR RIGID

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TENDERNESS

PALPATION OF LUMP

LOCAL TEMPERATURE

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TENDERNESS
CONFIRMING FINDINGS OF

INSPECTION

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MARGINS
CONSISTENCY
MOBILITY
PARIETAL,INTRA OR RETROPERITONEAL
PERCUSSION

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DULL OR RESONANT

FLUID THRILL

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AUSCULTATION

FOR RUB{ PERSPLENITIS OR

PERIHEPATITIS}

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INVESTIGATIONS

LABORATORY STUDIES-

ROUTINE,SPECIAL

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IMAGING STUDIES

TISSUE DIAGNOSIS-CYTOLOGY,HPE

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IMAGING STUDIES

X-RAY
USG
CT

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MRI
ERCP
NUCLEAR SCAN
PET
OTHER STUDIES

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ENDOSCOPY

ENDOSONOGRAPHY(EUS)

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DIFFERENTIAL DIAGNOSIS

SWELLINGS IN ABDOMINAL WALL
SEBACEOUS CYST
LIPOMA

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PARIETAL WALL ABSCESS
INTRAABDOMINAL LUMP

HEPATIC
GALL BLADDER

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SUBPHRENIC ABSCESS
STOMACH AND DUODENUM
HEPATIC FLEXURE OF COLON
RT KIDNEY
RT SUPRARENAL

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HEPATIC

IT MOVES WITH RESPIRATION,NOT

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SIDEWAYS

CONTINUOUS WITH LIVER DULLNESS

WITHOUT A BAND OF COLONIC

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RESONANCE
HEPATIC

ALA
PYOGENIC ABSCESS

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RIEDEL'S LOBE
HYDATID CYST
HEPATOMA
SECONDRIES
CIRRHOSIS

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SUBPHRENIC ABSCESS

PAIN RHC REFFERRED TO SHOULDER
TENDERNESS RHC

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SIGNS OF SEPTICAEMIA
RAISED DIAPHRAGM WITH GAS ON

XRAY

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CAUSATIVE CONDITIONS
LIVER ABSCESS
PERFORATED PEPTIC ULCER
GB LUMP

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OVAL,SMOOTH SWELLING,SIZE OF AN

EGG

MOVES WITH RESPIRATION

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GB LUMP

CA GALL BLADDER

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CA HEAD OF PANCREAS

CHOLEDOCHAL CYST

MUCOCOEL

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STOMACH AND DUODENUM

CA STOMACH

CONGENITAL HYPERTROPHIC PYLORIC

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STENOSIS

SUBACUTE PERFORATION OF PEPTIC

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ULCER

CA STOMACH

IRREGULAR FIRM LUMP

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MOVES WITH RESPIRATION

ELDERLY,ANOREXIA AND WT LOSS

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BARIUM MEAL--FILLING DEFECT

UPPER GI ENDOSCOPY
SUBACUTE PERFORATION OF

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ULCER

LOCALIZED TENDERNESS

INFLAMMATORY MASS

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HISTORY OF PEPTIC ULCER

BARIUM MEAL

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HEPATIC FLEXURE

PT ABOVE 40 YEARS
CHANGES IN BOWEL HABITS
OCCULT BLOOD

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ANAEMIA
LUMP-IRREGULAR,MOVES POORLY

WITH RESPIRATION

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COLONOSCOPY
INTUSUSSCEPTION

ABDOMINAL PAIN,VOMITINGS

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PASSAGE OF BLOOD AND MUCUS PER

ANUM(RED CURRANT JELLY)

CURVED,SAUSAGE SHAPED LUMP

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BARIUM ENEMA--PINCER ENDING OF

RADIOGRAPHIC MATERIAL

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KIDNEY SWELLING

BALLOTABLE

RENAL ANGLE IS FULL

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SLIGHT MOVEMENT WITH RESPIRATION

PERCUSSION-RESONANT
KIDNEY SWELLING

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HYDRONEPHROSIS/PYONEPHROSIS

CARCINOMA

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NEPHROBLASTOMA/WILMS TOMOUR

SUPRARENAL SWELLING

LIKE KIDNEY SWELLING

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CORTEX/ MEDULLA
ADRENAL CORTEX

HYPERPLASIA

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BENIGN ADENOMA

CARCINOMA

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ADRENAL MEDULLA

PHEOCHROMOCYTOMA

NEUROMA

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NEUROBLASTOMA