periode are unusual findings but should be easyly noted on physical examination so easy to palpate The location, mobility and characteristic of the mass determine the subsequent course of investigations. a highly mobile intra abdominal mass is probably a duplication or a mesenteric cyst Introduction .....
Most masses are retroperitoneal flank
masses and are relatively immobile. Differentiation among benign anomalies of the urinary tract and malignant tumors of renal, hepatic, or neural ganglion or adrenal origin can best achieved by planing sophisticated evaluation after thorough study of the intravenous pyelogram The following points of expansion of the table are cogent 1. Wilms tumor is a renal lesion.Distroetion of the calyces with some residual function is the usual pattern. large-size tumors may cross the midline, but calcification is unusual, when present it is coarse and easily seen on x-ray. hypertension may be present, possibly from renal artery stenosis. In the newborn period, renal tomurs are asually the more benign mesoblastic variant. Pulmonary metastases are highly unusual 2. Abdominal neuroblastoma, is usually (but not always) extrarenal and thus it displaces the kidney from its usual site. Distortion is less prominent. This tumor frequently crosses the midline. Fine, speckled calcifications are common but are usually not discrenible routine x-ray studies. Hypertension is common and may be accompanied by sweating, flushing, and diarrhea 3. Multicystic kidneys either a dysplastic kidney or the extreeme result of ureteral obstruction or atresia. Usually there is nonfunction on the intravenous pyelogram on the involved side 4. The intra abdominal cysts and intestinal duplications are highly mobile. The first sign of a duplication may be obstruction, frequently due intussusception of the duplication 5. Hepatic tumors are rarely accompanied by jaundice, whereas choledochal cyst almost invariably are. 6. Unless fairly certain diagnosis of a flank mass can be made preoperatively from intravenous pyelogram, the preoperative special studies 7. Retrograde pyelograms are unnecessary and probably contraindicated because pressure or manipulation may rupture a Willms tumor. If differentiation from obstructive uropathy is impossible from the intravenous study