CONGENITAL ANOMALIES THAT

PRESENT AS AN ABDOMINAL
MASS
Introduction

Abdominal masses in the newborn

periode are unusual findings but should
be easyly noted on physical examination
so easy to palpate
The location, mobility and
characteristic of the mass determine
the subsequent course of investigations.
a highly mobile intra abdominal mass
is probably a duplication or a
mesenteric cyst
Introduction .....

Most masses are retroperitoneal flank

masses and are relatively immobile.
Differentiation among benign anomalies
of the urinary tract and malignant
tumors of renal, hepatic, or neural
ganglion or adrenal origin can best
achieved by planing sophisticated
evaluation after thorough study of the
intravenous pyelogram
The following points of expansion of the
table are cogent
1. Wilms tumor is a renal lesion.Distroetion of
the calyces with some residual function is
the usual pattern. large-size tumors may
cross the midline, but calcification is unusual,
when present it is coarse and easily seen on
x-ray. hypertension may be present, possibly
from renal artery stenosis. In the newborn
period, renal tomurs are asually the more
benign mesoblastic variant. Pulmonary
metastases are highly unusual
2. Abdominal neuroblastoma, is usually
(but not always) extrarenal and thus
it displaces the kidney from its usual
site. Distortion is less prominent. This
tumor frequently crosses the midline.
Fine, speckled calcifications are common
but are usually not discrenible routine
x-ray studies. Hypertension is common
and may be accompanied by sweating,
flushing, and diarrhea
3. Multicystic kidneys either a dysplastic
kidney or the extreeme result of
ureteral obstruction or atresia. Usually
there is nonfunction on the intravenous
pyelogram on the involved side
4. The intra abdominal cysts and
intestinal duplications are highly mobile.
The first sign of a duplication may be
obstruction, frequently due
intussusception of the duplication
5. Hepatic tumors are rarely accompanied by jaundice,
whereas choledochal cyst almost invariably are.
6. Unless fairly certain diagnosis of a flank mass can be
made preoperatively from intravenous pyelogram,
the preoperative special studies
7. Retrograde pyelograms are unnecessary and probably
contraindicated because pressure or manipulation
may rupture a Willms tumor. If differentiation from
obstructive uropathy is impossible from the
intravenous study