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Updated 11 February 2013

Abdominal swelling

Abdominal swelling is an increase in the size (girth) of the abdomen, out of proportion to the rest of the body.

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Description

Abdominal swelling is an increase in the size (girth) of the abdomen, out of proportion to the rest of the body.

Causes and comments

The abdomen is made up of the walls, front and back, and the abdominal content: if any of these things enlarge, the abdomen will appear swollen. Additional fluid or gas collection can also cause enlargement.

Abdominal wall problems
These are few. General apparent swelling is usually due to fat deposition, so is usually part of overall weight gain.
Local swelling may be due to:

  1. Lipoma - a benign tumour of fat;
  2. Hernias – free or incarcerated; or
  3. Tumour deposits.

Abdominal cavity contents

  1. Ascites – free fluid in the abdominal cavity, usually associated with organ failure (heart or liver), or due to malignant deposits in the peritoneum.
  2. Gas – excess gas within the bowel, usually due to diet problems or enzyme deficiencies, air that has been swallowed, or partial or complete bowel obstruction.
  3. Gas in the peritoneal cavity, for instance, from a perforated bowel.

Organ enlargement
Any abdominal organ (liver, kidney, spleen, pancreas, kidney etc) may become enlarged due to:

  1. Infection such as hepatitis;
  2. Malignancy – lymphoma, enlarged spleen, ovarian cancer;
  3. Back-pressure – liver congestion due to heart failure;
  4. Congenital problems such as polycystic kidney disease;
  5. Obstruction, for instance leading to bowel distension; or
  6. Aortic aneurysm

Symptoms and diagnosis

Apart from the discomfort of the enlarged abdomen, the patient may have other specific symptoms and signs, like anorexia, jaundice or fever. These findings will suggest an underlying cause and guide the selection of tests. The large number of possible causes can be investigated by hundreds of different tests, but the most common are:

  1. Abdominal ultrasound;
  2. Abdominal scans;
  3. Full blood count;
  4. Gastroscopy or colonoscopy;
  5. Liver and kidney function tests; and
  6. Blood sugar and serum amylase (for pancreas function).

Treatment

Treatment will be according to the cause found on examination and testing.

(Dr. AG Hall)

 
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