Abdominal Masses in Children: A 10-Year Review

  • C. C. Nwokoro
  • O. M. Fatungase
  • B. A. Salami
  • A. O. Shonubi
  • A. O. Adekoya
  • A. A. Oyelekan
Keywords: Abdominal masses, Appendiceal mass, Children, Malignancy

Abstract

Background: Some childhood diseases present with abdominal masses alone or with other constitutional symptoms. The knowledge of the common causes of abdominal masses in children can assist in developing a protocol of management by clinicians.

Objective: To describe the aetiology and presentation of abdominal masses in children.

Methods: The hospital records of all cases of intra-abdominal masses in children managed between May 1998 and April 2008 were retrieved for analysis. Socio-demographic and clinical data were obtained and analysed using simple descriptive statistics.

Results: A total of 93 children were included while those without clinical, radiological and intra-operative evidence of intra-abdominal masses were excluded from the study. There were 49 males (52.7%) and 44 (47.3%) females with male-to-female ratio of 1.1:1. The children were aged 1 day to 14 years; 15 (16.1%) were aged <3 years while 23 (24.7%), 27 (29%) and 14 (15.1%) each were aged 3-6 years, >6-9 years, >9-12 years and >12-14 years. The most common cause of abdominal masses was appendiceal mass/abscess in 29%, followed by hydronephrosis in 22.6% and nephroblastoma in 16.11%. The most common symptoms included abdominal pain (86.0%), fever (46.2%), vomiting (40.9%) and abdominal distension (32.2%). The mortality rate was 13%.

Conclusion: Non-malignant conditions were mostly responsible for abdominal masses in children while abdominal pain, fever and vomiting were the leading presentations of abdominal masses in children.

Author Biographies

C. C. Nwokoro
Department of Surgery,
Olabisi Onabanjo University Teaching Hospital,
Sagamu, Ogun State, Nigeria
O. M. Fatungase
Department of Anaesthesia and Intensive Care, Olabisi Onabanjo University Teaching Hospital, Sagamu.
B. A. Salami
Department of Surgery, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
A. O. Shonubi
Department of Surgery, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
A. O. Adekoya
Department of Surgery, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
A. A. Oyelekan
Department of Surgery, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria

References

Romano D, Laurence YC. Abdominal mass. In: American College of Surgeons. Surgery. Principles and Practices. 2nd edition. New York. WebMD Corporation. 2002: 241-250.

Damien P, Kenneth VI. Mesenteric dermoid cyst in a child. Pan Afr Med J 2011; 10:41.

Golden CB, Feusner JH. Malignant abdominal masses in children: quick guide to evaluation and diagnosis. Pediatr Clin North Am 2002; 49:1369-1392.

Armand EB, Garrett MB. Abdominal masses in children: Neuroblastoma, Wilm’s tumor, and other considerations. Pediatr Rev 1991; 12: 196-206.

Cramer B, Pushpanathan C, Kennedy R. Non renal cystic masses in neonates and children. Can Assoc Radiol J 1993; 44: 93-98.

Schultz KA, Sencer SF, Messinger Y, Neglia JP, Steiner ME. Paediatric ovarian tumors: a review of 67 cases. Pediatr Blood Cancer. 2005; 44:167-173.

Horcher E, Helmer F. Benign and malignant intra-abdominal tumors in childhood. Wien Med Wochenschr. 1986; 31: 253-257.

Osifo OD, Eybuomwan I, Efobi CA. Management of Childhood abdominal masses by Nigerian traditional doctors: A worrisome cause of delay in presentation. Pak J Med Sci 2007; 23: 809-813.

Hanif G. Intra-abdominal tumors in children. J Coll Physicians Surg Pak 2004; 14: 478-480.

Cano MI, Ruiz PJA. Abdominal tumors in paediatric patients at Hospital San jose, Tec de monterrey: clinical and radiological correlations. Anales de Radiologia Mexico 2011; 10: 274-295.

Nam SH, Kim DY, Kim SC, Kim IK. The surgical experience for retroperitoneal mesentric and omental cyst in children. J Korean Surg Soc 2012; 83: 102-106.

Nwako FA. Abdominal Masses in Infants; A Textbook of Paediatric Surgery in the Tropics, The Macmillan Press Ltd, London. 1980; 165-169.

Jordan JS, Kovalcik PJ, Schwab CW. Appendicitis with a palpable mass. Ann Surg 1981; 193: 227-229.

Landry M, Mayor G, Queloz J. Appendiceal abscess. A challenge in abdominal masses in children. Radiol Clin (Basel). 1975; 44: 432-439.

Papaioannou G, Mchugh K. Investigation of an abdominal mass in childhood. Imaging 2004; 16: 114-143.

James AO, Jay LG, Eric WF, Arnold GC, Anthony AC. Tumors. In: Principles of Paediatric Surgery. 2nd edition. Missouri. Mosby. 2004: 209-228.

Annuar Z, Sakijan AS, Annuar N, Kooi GH. Ultrasound in the diagnosis of palpable abdominal masses in children. Med J Malaysia. 1990; 45: 281-287.

Sarah SM, Edward YL, Carlo B, Rober T. Ultrasound evaluation of paediatric abdominal masses. Clinics Review Articles. 2007; 2: 541-559.

Sung KW. Differential diagnosis of abdominal masses in children. Korean J Pediatr 2008; 51: 787-791.

Adegboyega AO, Osuoji IR, Akinola AR, Balogun BO, Faturoti OI, Awosanya GO. Pattern of computed tomography scan findings in children with Wilm’s tumor in a tertiary hospital in Lagos, Nigeria. Indian J Med Pediatr Oncol 2014; 35: 31-35.

Published
2016-03-24
Section
Articles

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