Lump in the abdomen

Definition:

A lump in the abdomen is a soft bulge of tissue or a small area of swelling in the belly.

Alternative Names:

Abdominal hernia; Hernia - abdominal; Abdominal wall defects; Lump in the abdominal wall; Abdominal wall mass

Common Causes:

Most often, a lump in the abdomen is caused by a hernia. An abdominal hernia occurs when there is an area where the muscles are weak. This allows the internal organs to bulge through the abdominal wall. A hernia may not appear until after you strain, lift something heavy, or have a long period of coughing.

There are several types of hernias, based on where they occur:

Inguinal hernia appears as a bulge in the groin or scrotum. This type is more common in men than women.
Incisional hernia can occur through a scar if you have had abdominal surgery.
Umbilical hernia appears as a bulge around the belly button. It occurs when the muscle around the navel doesn't close completely.

Other causes of a lump in the abdominal wall include:

Hematoma (collection of blood under the skin after injury)
Lipoma (collection of fatty tissue under the skin)
Lymph nodes
Undescended testicle
Tumor of the skin or muscles

Home Care:

Get treated for a chronic cough or constipation if you have a hernia. Straining from these conditions causes the intestines to bulge further into the hernia.

Call your health care provider if:

Call your doctor if you have a lump in your abdomen that becomes larger, changes color, or is painful.

If you have a hernia, call your doctor if you have:

A hernia that looks abnormal
Fever
Pain or tenderness around the hernia
Vomiting

The blood supply to the organs that stick out through the hernia may be lost (strangulated hernia). This is very rare, but it is a medical emergency.

What to expect at your health care provider's office:

The doctor will examine you and ask questions about your medical history and symptoms, such as:

Where is the lump located?
When did you first notice the lump in your abdomen?
Is it always there, or does it come and go?
How large is the lump? Try to measure the distance across (diameter), or compare it to another object (the size of a baseball, for example).
Does anything make the lump bigger or smaller?
What other symptoms do you have?

During the physical examination, you may be asked to cough or strain.

Surgery may be needed to correct incisional hernias or umbilical hernias that do not go away by the time a child approaches school age. The surgery may be done through a large surgical cut, or through a smaller cut into which the surgeon inserts a camera and other instruments.

Emergency surgery is needed in the case of a strangulated hernia.

References:

Malangoni MA, Rosen MJ. Hernias. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 44.

Turnage RH, Richardson KA, Li BD, McDonald JC. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 43.