There could be many causes of swelling in the hypogastrium region. It is important to keep these diagnoses in mind when one is encountered with swelling in hypogastrium region.
Hypogastrium is also called also called the hypogastric region or suprapubic region. Hypogastrium refers to a region of the abdomen located below the umbilical region. The pubis bone constitutes its lower limit.
In literal sense, the word hypogastrium means below the stomach.
The swelling could be from all the layers or organs of the abdomen in that region. As a standard approach, guide to examination of abdomen should be followed for all cases of swelling in hypogastruim
Swelling in parietal layer
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
Uterus and its Appendages
Spherical midline swelling above symphysis pubis harder than urinary bladder (it should be a rule to exclude swelling of the bladder by passing a catheter before concluding that it is uterine swelling).
Fallopian Tube and Ovary
A. Chronic Salpingitis
1. Attack of pelvic peritonitis: Pain, fever and bladder disturbances
2. Mass in the midline or on one or other side of the midline
3. Vaginal examination confirms the diagnosis
B. Ovarian Cyst or Tumor
1. Mass arising from one side of the pelvis but later on may become central
2. Menstruation normal or scanty
3. Vaginal examination confirms attachment to the uterine appendages
4. Swelling has dullness over the front of the abdomen with resonance in the flanks (In ascites resonance in the center and dullness in the flanks)
C. Ruptured Tubal Gestation
1. History of missed periods
2. A lump few days after the leakage
It may follow acute appendicitis, salpingo-oophoritis and puerperal sepsis.
1. Constitution symptoms
2. Copious discharge of mucus per rectum and frequency of micturition.
3. Rectal examination reveals bulging of the anterior wall of the rectum.
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