Edema in the stomach
An increase in the abdomen in the epigastric region can occur due to:
1. Anterior abdominal wall
- Epigastric hernia
- Ossification of the xiphoid process
- Metastatic nodes
- Congenital hypertrophic stenosis of the pylorus
- Acute zvorot stomach
4. Transverse colon
- Accumulation of feces
- Swelling of the diverticulum
Enlarged abdomen in the epigastric region and abdominal wall
The patient may complain of the appearance under the skin of a soft to the touch protrusion, which can be a lipoma or epigastric hernia containing preperitoneal fat.
Epigastric hernia is formed along the midlinebelly through a defect of the white line. In case of infringement the tumor-like protrusion becomes painful, around it reddening of the skin is marked.
Sometimes the patient complains of dense boneformation in the upper part of the epigastric region, which turns out to be a common xiphoid process. The patient notices this with a deliberate attempt to lose weight or a rapid loss of body weight due to some disease.
Metastases, such as tumors of the mammary glands or bronchial tubes, can be detected in the form of sedentary tumors in the skin or subcutaneous tissue.
Determined by palpation soft, lobularthe tumor is most likely a lipoma. This tumor can remain mobile with the tension of the muscles of the anterior abdominal wall. Motionless, sometimes painful palpation of the wen, located along the midline of the abdomen, suggests the presence of epigastric hernia. Epigastric hernia in most cases consists of preperitoneal fat, although the contents of the hernial sac can be a small intestine. When palpation you can feel a cough push. Tumor formation in the case of epigastric hernia can be corrected.
Solid tumor-like formations in the regionof the anterior abdominal wall, irregular in shape and immobile in palpation, are most likely metastases, especially if the patient has breast cancer or bronchogenic lung cancer.
Increase of abdomen in epigastric region and stomach
The child may experience vomiting with a "fountain". A normally developing baby during 3-4 weeks suddenly develops indomitable "gushing" vomiting food. This pathology, as a rule, occurs in the first-born boy. In this case, it is necessary to find out the hereditary history and the presence of such a disease in relatives, especially on the maternal line.
Enlarged abdomen in the epigastric region and retroperitoneal space
Complaints of the patient for pain in the lumbar region or pulsating tumor-like formation in the epigastric region may indicate the presence of an aneurysm of the abdominal aorta.
Pain in the lumbar region can be observed with lymphadenopathy (enlarged lymph nodes) of the retroperitoneal space.
When palpation of the abdominal cavity can be detectedpulsating tumor-like formation. Palpate the pulsation of the arteries of the lower extremities (acute occlusion of the artery in the result of the embolism is accompanied by the development of limb ischemia). Metastases in the retroperitoneal lymph nodes in testicular cancer can manifest as a large retroperitoneal tumor. At palpation, exclude a testicular tumor. Palpate all areas of possible enlargement of the lymph nodes (especially the left supraclavicular node). The cause of enlarged lymph nodes may be lymphoma. Exclude enlarged lymph nodes in all accessible areas and splenomegaly. Identification of a dense, uneven and mobile tumor-like formation in palpation, especially when the patient has ascites, allows us to suspect a secondary lesion of the omentum (ovarian cancer, stomach - check the Virch node, ie the node in the left supraclavicular area).
Diagnosis with an increase in the abdomen in the epigastric region
For differential diagnosis with an increase in the abdomen in the epigastric region, additional studies are carried out:
- OAK, ESR. Hb - stomach cancer, colon cancer, carcinomatosis. Leukocytosis - diverticulitis.
- Urea and electrolytes. Vomiting and dehydration with lesions of the stomach and large intestine.
- Functional liver tests. Lesions of the liver.
- Ultrasound. Aneurysm of the aorta, lymphadenopathy, false pancreas cyst
- Blood glucose. Increased blood glucose levels can occur with pancreatic cancer or previous pancreatitis.
- CT. Tumors, false cysts of the pancreas. Lymphadenopathy. Aneurysm of the aorta. Metastatic damage to the omentum. It is necessary to confirm biopsy data (ABTI - aspiration biopsy with a thin needle for cytological examination).
- Barium enema. Cancer of the colon. Diverticulosis.
- Colonoscopy. Cancer of the colon. Diverticulosis.
- Gastroscopy. Stomach cancer.
- Laparoscopy. Ovarian cancer. Transition of the carpinomatous process to the epiploon. Peritoneal carcinomatosis.
E. Rafteri, E. Lim