Churchills Pocketbook of Differential Diagnosis

Abdominal Swellings 13
Pancreatic tumours may be impalpable or present as a fixed mass,
which does not move with respiration. Pancreatic pseudocysts
are often large, smooth and may be tender.
Colon
See right upper quadrant, p. 9.
GENERAL INVESTIGATIONS
SUBASH KC/NMC-15TH/2014
■■
FBC, ESR
Hb carcinoma. Hb hypernephroma (polycythaemia is
associated with hypernephroma). WCC diverticular disease,
renal infections.
■■
U&Es
Vomiting, dehydration (with gastric and colonic lesions). Renal
lesions.
■■
LFTs
Liver lesions. Secondary deposits in liver.
■■
Serum amylase
Acute pancreatitis.
■■
US
Splenomegaly. Renal lesions. Paracolic abscess.
SPECIFIC INVESTIGATIONS
■■
Blood glucose
May be raised in pancreatic carcinoma.
■■
Barium enema
Carcinoma. Diverticular disease.
■■
Colonoscopy
Carcinoma. Diverticular disease.
■■
Gastroscopy
Carcinoma of the stomach. Pyloric stenosis.
■■
CT
Carcinoma of the pancreas. Pancreatic pseudocyst. Liver
secondaries. Splenomegaly. Paracolic abscess.
EPIGASTRIUM
Many of the swellings that occur here will have been described
under swellings in other regions of the abdomen. Although a full
list of epigastric swellings is given below, only those not referred to
in other sections will be discussed in the history and examination
sections.
Section A