Differential Diagnosis of Abdominal Lump In Right Hypochondrium
Swellings in the Abdominal Wall
Cold Abscess
1. Fluctuant swelling with no signs of inflammation
2. Swelling becomes prominent when the abdominal muscles contract
3. Irregularity in the affected rib or deformity of the spine
Intra-abdominal Swellings
Hepatic
1. It moves with respiration but is not mobile sideways
2. The swelling is continuous with the liver dullness without a band of colonic resonance
Gall Bladder
1. Oval smooth swelling, the size of an egg
2. Moves with respiration, can be moved sideways but cannot be pushed down into the loin (like kidney swelling) Read more
What Are Variants of Acute Viral Hepatitis?
Hepatitis can assume varied forms depending on type & severity of infection and individual immunity.It can be of following forms
Fulminant hepatitis
There is rapid onset of liver failure due to rapid liver cell necrosis which occurs due to modification of host response to viral infection, allowing rapid viral replication Hepatitis B and C and superinfection with delta agent accounts for majority of the cases.
Mortality in 3 weeks is 30 percent and 90-100 percent above age 60 die. Read more
Prevention of Viral Hepatitis
Prevention is an important aspect of disease control. For hepatitis prevention a good hygiene and good habits play important role.
The patient should avoid salivary transmission to others by avoiding kissing, spitting, sharing food, cigarettes or utensils and sexual contact.
Infected stools and urine in Hepatitis A and E must be disposed off carefully.
Another method of protection is immunization against the disease.
Immunization
Hepatitis A
All immune globulin (Ig) preparations contain anti-HAV. It should be given within 2 weeks of contact in the dose of 0.02 ml/kg. For travelers a dose 0.06 ml/kg should be given every 6 months.
Now vaccination of hepatitis A is also available and even included in national vaccination schedule. Read more
Causes of Swelling In Hypogastrium
Parietal Swellings
Swelling in parietal layer
Urinary Bladder
1. Globular swelling in the hypogastrium which may extend from symphysis pubis to the umbilicus
2. The lump is tender and dull on percussion
3. Pressure induces a desire for micturition
Few Tips On Survival In Times Of Swine Flu
Swine flu is an illness which derives its name from a communicable virus that infects pigs. Once it comes to humans, the the virus can be transmitted from one person to another.
The symptoms of swine flu are like those manifested in a regular flu and may include cough, sore throat, body aches, headache, fever, chills and fatigue.
While government agencies are working on control of the outbreak, it is also necessary for people to educate themselves about this disease. Read more
What Is Scope of Swine Flu?
The World Health Organization has raised its alert level to 6. The WHO revealed that the influenza virus has the sustainability for human-to-human transmission and can cause community level outbreaks.
A similar outbreak known as bird flu was more risky than H1N1 virus. According to Professor Neil Ferguson of the World Health Organization, H1N1 is nothing when compared to other similar outbreaks such as SARS or the 1918 Spanish flu. Read more
Alcoholic Hepatitis
Alcoholic hepatitis is an inflammatory lesion characterized by infiltration of the liver with leucocytes, liver cell necrosis and alcoholic hyaline deposition.
Pathology
Liver cells are ballooned, degenerated and necrosed with infiltration with polymorphs and lymphocytes. Hepatocytes contain Mallory bodies or alcoholic hyaline which are clumps of perinuclear, deeply eosinophilic material that represents intermediate filaments.
Mallory bodies are also seen with morbid obesity, jejuno-ileal shunt, uncontrolled diabetes mellitus, Wilson’s disease, Indian childhood cirrhosis, etc. Read more
Alcoholic Fatty Liver
Alcoholic fatty liver (AF) occurs in most heavy drinker but is reversible on cessation of alcohol consumption.
Pathology
The liver is enlarged, greasy, yellow and firm. Hepatocytes are distended with fatty vacuoles which pushes the nucleus to the periphery. This occurs because fatty acid oxidation is impaired and they are taken up by the cells and esterified to form triglycerides. Read more
Acute Viral Hepatitis
Acute viral hepatitis can be caused by any one of the Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis E and Delta viru,Epstein-Barr virus, cytomegalovirus, herpes simplex virus, rubella virus and virus of yellow fever.
Hepatitis A Virus
This is a RNA virus transmitted by fecoral route. Incubation period is 2-6 weeks. It leads to acute hepatitis and does not lead to chronic disease or carrier state. Jaundice does not occur in half of the patients.
Hepatitis B Virus
This is a DNA virus transmitted parenterally or sexual intercourse. Workers dealing with blood products are at a higher risk.. The incubation period is 2-25 weeks. About 10 percent patients develop chronic disease or a carrier state. Read more
How To Examine An Abdominal Lump
General Physical Examination
Appearance: Anemic, jaundiced or emaciated, Lymph nodes, especially supraclavicular.
Local Examination
Inspection:
- Overlying skin
- Position, size, shape and surface of the swelling
- Movement of swelling on respiration
- Check sites of hernia
- Observe scrotum for any fullness
Palpation: Read more