JINKA UNIVERSITY

CMHS
DEPARTMENT OF PHO
SAWLA GENERAL HOSPITAL
IM WARD
SEMINAR ON DDx OF ABDOMINAL SWELLING

BY KUME.K
Out Comes
• Definition of abdominal swelling
• Causes of abdominal distension
• DifferentialDiagnosisof Abdominal Swelling
• Management of abdominal swelling
• Treatment of Abdominal swelling
Abdominal swelling is a general condition in
which the abdomen is distended or enlarged.
Abdominal swelling can be associated with a
sensation of fullness, bloating, stretching, or
pain and is usually associated with an increase
in overall girth.
Common symptoms of Abdominal Swelling
Burning sensation in chest or abdomen
Diarrhea ,constipation ,Gas And Vomiting
Causes of abdominal distension
Differential Diagnosis of
Abdominal Swelling
• Ascites
• Ovarian cysts
• Gastrointestinal Obstruction
• Inflammatory bowel disease
• Pancreatitis
• Kidney disease
• Heart failure
• Enlarged organs
• Peritonitis
• Constipation
ASCITES
• Ascites is a condition in which fluid collects in
spaces within your abdomen
• What causes ascites?
• The most common cause of ascites is cirrhosis of
the liver.
• Drinking too much alcohol is one of the most
common causes of cirrhosis of the liver.
How ascites Cause abdominal
swelling ?
• Ascites can cause abdominal swelling because it involves
the accumulation of fluid in the abdominal cavity.
• Normally, there is a small amount of fluid present in this
space, but in ascites, there is an abnormal buildup of fluid.
• This excess fluid puts pressure on the abdominal organs,
causing them to push outward and resulting in abdominal
swelling.
• Overall, ascites causes abdominal swelling by the
accumulation of fluid in the abdominal cavity, which puts
pressure on the organs and leads to their outward
displacement.
• 2. Ovarian cysts: These fluid-filled sacs on the
ovaries can cause abdominal swelling, but they can
also be asymptomatic or cause other symptoms
such as pelvic pain.
• How can ovarian Cyst cause Abdominal swelling
• Ovarian cysts can cause abdominal swelling due to
their size and location.
• Ovarian cysts are fluid-filled sacs that develop on or
within the ovaries.
• When these cysts grow larger, they can put
pressure on surrounding organs and tissues,
including the abdomen.
•
•
 KIDNEY DISEASES
Kidney disease: Conditions like chronic kidney
disease or kidney failure can cause fluid
retention and abdominal swelling.
How can kidney disease Cause abdominal
swelling?
Kidney disease can cause abdominal swelling
through a condition called ascites.
In kidney disease, the kidneys may not be able
to effectively remove excess fluid and waste
products from the body, leading to fluid
retention.
This fluid can accumulate in the abdominal
cavity, causing swelling and distension.

Furthermore, kidney disease can also lead to

a decrease in the production of albumin, a
protein that helps maintain fluid balance in the
body.
 When albumin levels are low, fluid can leak
out from blood vessels into surrounding
tissues, including the abdomen, leading to
swelling. N.B normal albumin 3.4 -5.4 g/dl
 Heart failure (HF),
Heart failure (HF), often referred to as congestive heart
failure (CHF), occurs when the heart is unable to pump
sufficiently to maintain blood flow to meet the body's
needs.
Heart failure can cause abdominal swelling through a
mechanism called hepatic congestion
When the heart is unable to pump blood effectively, it can
lead to a backup of blood in the veins that carry blood from
the digestive organs to the liver (known as the portal vein).
This congestion increases pressure in the veins of the liver,
resulting in fluid leakage into the abdominal cavity.

 Enlarged organs
Enlarged organs: Enlargement of organs such as the liver
(hepatomegaly) or spleen (splenomegaly) can cause
abdominal swelling.
How can Enlarged Organs Cause abdominal swelling?
Enlarged organs can cause abdominal swelling by
exerting pressure on surrounding tissues and
 disrupting the normal flow of fluids in the abdomen.
 When an organ becomes enlarged, it can compress blood
vessels and lymphatic channels, leading to fluid
accumulation in the abdominal cavity.


For example, in conditions such as liver disease or
heart failure, the liver or heart can become enlarged
and obstruct the normal flow of blood through the
veins.
This can result in increased pressure in the veins that
drain blood from the abdomen, causing fluid to leak
out into the abdominal cavity and causing swelling.
 Similarly, an enlarged spleen (splenomegaly) can
also contribute to abdominal swelling.
The spleen plays a role in filtering blood and
removing old or damaged red blood cells.
When the spleen becomes enlarged, it can trap
excessive amounts of fluid and blood cells, leading to
fluid
Inflammatory bowel disease (IBD)
Inflammatory bowel disease (IBD): Conditions like Crohn's disease
and ulcerative colitis can cause abdominal swelling and other
symptoms such as diarrhea, pain, and weight loss.
How IBD Cause abdominal Swelling?
(IBD), can cause abdominal swelling through several mechanisms.

One of the primary reasons for abdominal swelling in IBD is
inflammation of the intestines.
Inflammation can lead to the thickening of the intestinal walls and
the formation of scar tissue.
This can result in a narrowing of the intestines, making it difficult
for stool to pass through and causing a buildup of gas and stool in
the affected area.
The accumulation of gas and stool can lead to abdominal
distension and bloating.
• IBD can also disrupt the normal
absorption and digestion of food
• When the intestines are inflamed,
they may not be able to properly
absorb nutrients and fluids from
food.
• This can result in malabsorption
and diarrhea, leading to fluid
retention in the intestines and
subsequent abdominal swelling.
IBD Cont...
Furthermore, IBD can cause complications such as
intestinal strictures or blockages.
These occur when the inflammation and scarring
narrow the intestinal passage, making it difficult for
food and waste to move through.
The accumulation of food and waste behind the
stricture can cause distension and swelling of the
abdomen.


Peritonitis
Peritonitis is a condition characterized by inflammation of the
peritoneum, which is the membrane lining the abdominal cavity.
Abdominal swelling can occur in peritonitis due to several
reasons:

1. Infection: Peritonitis often occurs as a result of bacterial or
fungal infection, which can cause the peritoneum to become
inflamed and swollen.
The infection can spread throughout the abdominal cavity,
leading to fluid accumulation and swelling.

2. Fluid accumulation: In response to the infection and
inflammation, the body may produce excess fluid in the
abdominal cavity.
Peritonitis cont...
3. Immune response: The immune system plays a role in
the inflammatory process during peritonitis
Immune cells release substances that promote
inflammation, which can cause fluid leakage and swelling
in the abdomen.
4. Complications: If left untreated or if the infection is
severe, peritonitis can lead to complications such as
abscess formation or perforation of the abdominal organs.
These complications can cause further inflammation and
fluid accumulation, contributing to abdominal swelling.

Constipation
• Constipation refers to bowel movements that are
infrequent or hard to pass.
• Constipation is a common cause of painful
defecation.
• Severe constipation includes obstipation (failure to
pass stools or gas) and fecal impaction, which can
progress to bowel obstruction and become life-
threatening.
Constipation
• Constipation can cause abdominal swelling due to
• the buildup of stool in the intestines.
• When stool remains in the colon for an extended period, it can
cause the abdomen to become distended and bloated.
• can also lead to the formation of gas in the intestines.
• When stool remains in the colon, bacteria break it down,
producing gas as a byproduct.
• This gas can further contribute to abdominal swelling and
discomfort
• severe constipation can also lead to a condition called fecal
impaction, where a large mass of hardened stool becomes stuck
in the rectum or colon.
•
treatment of abdominal swelling
Some possible treatment options include:

1. Medications: If the abdominal swelling is due to fluid retention, diuretics may be
prescribed
2. Dietary changes: This may involve reducing salt intake, avoiding certain foods that
can cause bloating or gas, and increasing fiber intake to promote regular bowel
movements.

3. Lifestyle modifications: such as losing weight, quitting smoking, and reducing
alcohol consumption can help improve abdominal swelling in some cases.

4. Surgical interventions: if the swelling is due to an abdominal hernia or a tumor,
surgical removal may be required.

5. Symptom management:.


diagnose of abdominal swelling

1. Blood tests: evaluate liver and kidney function, check for infection or
inflammation

2. Imaging tests: Imaging tests such as ultrasound, CT scan, or MRI may be

ordered to visualize the organs and structures in the abdomen and identify
any abnormalities.

3. Endoscopy: In some cases, an endoscopy may be performed to examine

the gastrointestinal tract and obtain tissue samples for further analysis.

4. Biopsy: If a tumor or abnormal growth is suspected, a biopsy may be

performed to obtain a sample of the tissue for examination under a
microscope.
•
THANKS
FOR YOUR
PATIENCE'S