Abdominal Swelling & Ascites

Question 0

Signs

a. Metastatic abdominal malignancy
b. Chronic hepatic disease

Answer 0

a. Metastatic Abdominal Malignancy
- lymphadenopathy, especially supraclavicular lymphadenopathy (Virchow’s node)

b. Chronic Hepatic Disease
- Spider angiomas, palmar erythema, dilated superficial veins around the umbilicus (caput medusae), and gynecomastia

Question 1

Causes of Abdominal Swelling

Answer 1

six Fs: flatus, fat, fluid, fetus, feces, or a “fatal growth”

Question 2

Minimum volume to detect ascites in PE

Answer 2

1500mL

Question 3

Ascites w/o cirrhosis is due to…

Answer 3

peritoneal carcinomatosis, peritoneal infection, or pancreatic disease

Peritoneal carcinomatosis can result from primary peritoneal malignancies such as mesothelioma or sarcoma, abdominal malig- nancies such as gastric or colonic adenocarcinoma, or metastatic disease from breast or lung carcinoma or melanoma
The tumor cells lining the peritoneum produce a protein-rich fluid that contributes to the development of ascites

Tuberculous ascites