Abdominal Swelling in Adults - Differentials

Abdominal swelling in adults is a common clinical presentation in primary care, encompassing a wide range of potential etiologies from benign to life-threatening conditions. The approach to managing abdominal swelling requires a systematic and thorough evaluation. This begins with a detailed history taking, focusing on the location, character, and associated symptoms of the swelling. Understanding whether the swelling is generalized or localized to specific quadrants (upper, lower, right, left) and characterizing it (soft, hard, tender, mobile, fixed) provides initial clues to the underlying cause. Associated symptoms like nausea, vomiting, fever, chills, fatigue, changes in bowel habits, and urinary symptoms are crucial for contextualizing the swelling within a broader clinical picture.

The initial physical examination, including palpation and inspection of the abdomen, is followed by first-line investigations. These often include abdominal ultrasound, CT or MRI for detailed imaging, and basic laboratory tests such as complete blood count, urinalysis, liver function tests, and stool tests, including the Fecal Immunochemical Test (FIT) for gastrointestinal disorders. This integrated approach aids in diagnosing the cause of abdominal swelling, guiding further management, and determining the need for specialist referral. Early and accurate diagnosis is key to improving outcomes and tailoring appropriate treatment strategies for patients presenting...