Abdominal Masses

Surgery

Assumptions
Student is familiar with the normal location, size and consistency of the abdominal viscera.

Knowledge Objectives
Through their reading and patient care experiences, at the end of the rotation students should be able to:

Describe the causes of hepatomegaly

Discuss the role of liver function testing, radionucleotide imaging, ultrasound and CT scanning in the evaluation of hepatomegaly.
Discuss the most frequently encountered benign hepatic tumors and their management.
Discuss the most frequently encountered malignant hepatic tumors and their management.
Discuss the role of liver biopsy in the diagnosis and the available techniques.
Understand the importance of hepatitis C and B prevention in relation to hepatoma.

Describe the causes of splenomegaly.

Discuss the most common signs and symptoms associated with hypersplenism.
Compare and contrast hypersplenism with an enlarged and normal sized spleen.
Discuss the role of splenectomy in the treatment of hypersplenism.
Discuss the consequences of hyposplenism and how can these be diminished.
Discuss the short and long term complications associated with surgical removal of the spleen.

Describe the differential diagnosis of a pancreatic mass.

Discuss the most useful diagnostic studies.
Discuss the relationship of the pancreatic duct to the common bile duct and how this may impact diagnosis and treatment of pancreatic lesions.
Discuss the indications and techniques of biopsy the pancreas.
Discuss the management of cystic lesions of the pancreas.
How do you differentiate a pseudocyst from a cystadenoma or true cyst?
Which patients need surgery and when?
What are the major complications of pancreatic necrosis and pseudocyst formation?

Describe the most frequently encountered retroperitoneal masses.

Discuss the appropriate imaging studies and work up for these tumors.
Discuss the most frequently encountered lymphomas and their treatment.
Discuss the most common retroperitoneal sarcomas and their management.

Describe the evaluation and management of abdominal aortic aneurysms.

Discuss appropriate imaging studies for aneurysms.
Discuss which patients need angiograms.
Discuss the relationship of aortic aneurysms to other vascular aneurysms.
Discuss how to determine which patients need surgical repair of the aneurysm.
Discuss the risks of surgical treatment and the risks of the aneurysm left untreated.

Describe the appropriate screening for aneurysm disease prior to age 60 in patients with a family history of aortic aneurysm.

Describe the tumors most frequently associated with abdominal carcinomatosis and omental metastasis.