Abdominal Masses
An abdominal mass is a lump felt in your tummy (abdomen). There are many different causes of an abdominal mass. You must see a doctor as soon as you think you can feel a mass in your abdomen because you may need urgent investigations and treatment.
What is an abdominal mass?
An abdominal mass is a lump in your tummy (abdomen). Your abdomen contains many different structures, including your:
- Stomach and gut (bowel).
- Liver.
- Spleen.
- Pancreas.
- Kidneys and bladder.
- Womb (uterus) and ovaries in women.
- Major blood vessels - for example, the aorta.
The exact position of the mass will help to determine what structure the mass is coming from. See the section 'What are the Causes of an abdominal mass?' below.
The abdomen can be divided into nine areas:
- Just below your ribs on the right side (right upper quadrant).
- Just below your ribs in the middle (epigastrium).
- Just below your ribs on the left side (left upper quadrant).
- Right side of your middle abdomen (right loin).
- Around your tummy button (periumbilical).
- Left side of your middle abdomen (left loin).
- Right side of your lower abdomen (right lower quadrant).
- Middle of your lower abdomen (suprapubic and pelvis).
- Left side of your lower abdomen (left lower quadrant).
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What are the symptoms of an abdominal mass?
Although you may feel a lump (mass) in your tummy (abdomen), the mass is often first felt by a doctor examining your abdomen for a different symptom, such as abdominal pain.
Therefore, in the first instance, you are more likely to be aware of a mass caused by a problem with your gut (bowel) because of other symptoms such as abdominal pain, diarrhoea, constipation, rectal bleeding or weight loss. A mass in your kidney may also cause blood in your urine. Any other symptoms you get will depend on exactly where the mass is and the cause of the mass.
What are the causes of an abdominal mass?
The possible cause of the lump (mass) in your tummy (abdomen) will depend on where it is in your abdomen. The following lists are examples of the more common causes of an abdominal mass in each area. A lump (swelling) that can be seen and felt over the front of the abdomen (abdominal wall) may be a skin lump or a hernia.
Right upper quadrant
- Liver: enlarged liver (hepatomegaly), liver cancer. There are many causes of an enlarged liver, including infection, heart failure, cancer, alcoholic liver disease and fatty liver disease.
- Gallbladder: cholecystitis, cancer of the bile duct in the liver (cholangiocarcinoma).
Epigastrium
- Stomach: for example, stomach cancer.
- Pancreas: for example, an abscess or cancer of the pancreas.
Left upper quadrant
- Spleen: enlarged spleen (splenomegaly). There are many causes of an enlarged spleen, including leukaemia, lymphoma, thalassaemia, sickle cell disease, malaria and glandular fever.
- Stomach: for example, stomach cancer.
- Pancreas: for example, an abscess or cancer of the pancreas.
- Gut (bowel): for example, colon cancer.
- Kidney: for example, kidney cancer.
Right loin
- Kidney: for example, kidney cancer.
Periumbilical
- Enlarged part of the major blood vessel (aorta): aortic aneurysm.
Left loin
- Kidney: for example, kidney cancer.
Right lower quadrant
- Bowel: for example, colon cancer.
- Kidney: for example, kidney cancer.
- Ovary: for example, cancer of the ovary.
Suprapubic and pelvis
- Bladder: for example, a distended bladder caused by a blockage preventing you from emptying your bladder - such as in prostate gland enlargement in men.
- Womb (uterus): for example, pregnancy, fibroids.
- Ovary: for example, ovarian cyst, ovarian cancer.
Left lower quadrant
- Bowel: for example, colon cancer, diverticular disease.
- Kidney: for example, kidney cancer.
- Ovary: for example, cancer of the ovary.
What tests are needed for an abdominal mass?
Initial tests will include blood tests. Further tests may include a urine test, an abdominal ultrasound scan, a CT scan or an MRI scan. Any further tests will depend on the likely underlying cause of the intestinal malabsorption.
Editor's note
Dr Sarah Jarvis, 11th February 2021
The National Institute for Health and Care Excellence (NICE) updated its guidance (recognising and referring people with possible symptoms of cancer) in September 2020 and in January 2021.
As a result, if you are a woman and your doctor finds evidence of fluid inside the tummy (called ascites) or a mass in your pelvis or tummy when they examine you, they should refer you urgently to the women's health cancer service. The only exception is if the lump is obviously caused by fibroids in your womb.
It is important to remember that in most cases, no cancer will be found. However, it is very important that tests be done to exclude cancer as soon as possible.
What is the treatment for an abdominal mass?
The treatment will depend on the cause of the abdominal mass. There are many serious causes of an abdominal mass so you must see a doctor as soon as you think you can feel a mass in your tummy (abdomen).
Further reading and references
Suspected cancer: recognition and referral; NICE Clinical Guideline (2015 - last updated January 2021)