Movable Abdominal Mass: Causes and When to Seek Help

A movable mass can be palpated in the abdomen?

Hello Dr.
Chen, I have a son, and about two years ago (approximately six months postpartum), while lying flat in bed at night, I suddenly felt a protrusion or hard lump above my navel and below my rib cage.
This hard lump seems to move around between the area above my navel and below my rib cage, and it is more noticeable on the right side of my abdomen, with less sensation on the left side.
Whenever I pay special attention, I can feel it while lying down before sleep.
Initially, I thought it was just air in my abdomen and didn’t think much of it, as I had no discomfort.
However, recently I have been able to feel that lump even while standing or sitting, and it gives a slight tight sensation.
On one occasion, besides being able to feel it while lying down, I could even see the lump protruding or sinking under the skin while standing in front of a mirror.
If I apply slight pressure to this hard lump, there is a bit of pain, but it immediately shifts position.
Could this be a symptom caused by excessive gas in the abdomen, possibly stagnating in the intestines or stomach? Should I go to the hospital for an examination? Thank you!

Mi Mi Mao, 30~39 year old female. Ask Date: 2001/03/19

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, based on your description, it seems that the issue may not be solely related to gas.
I recommend seeing a gastroenterologist for an evaluation.
Wishing you good health!

Reply Date: 2001/03/19

More Info

Understanding a movable abdominal mass can be concerning, especially when it presents with changes in sensation or discomfort. Based on your description, it seems that you have been experiencing a palpable mass in your abdomen that moves and is more pronounced when you are lying down. This mass is located between your navel and rib cage, primarily on the right side, and you have noted that it can be painful when pressed.

There are several potential causes for a movable abdominal mass, and it is essential to consider these in the context of your overall health and any accompanying symptoms. Here are some possibilities:
1. Hernia: One of the most common causes of a movable mass in the abdominal area is a hernia. This occurs when an internal organ or tissue protrudes through a weak spot in the abdominal muscles. In your case, if the mass is more prominent when lying down and can be pushed back in, it could indicate a hernia, such as an inguinal or umbilical hernia.

2. Lipoma: A lipoma is a benign tumor made of fat tissue that can occur anywhere in the body, including the abdomen. These are usually soft, movable, and painless, but they can sometimes cause discomfort if they press on surrounding structures.

3. Cysts or Abscesses: Fluid-filled sacs (cysts) or collections of pus (abscesses) can also present as palpable masses. These may be associated with infection or inflammation and can cause pain or discomfort.

4. Bowel Distension: As you mentioned, excessive gas or bowel distension can sometimes create a feeling of fullness or a mass-like sensation in the abdomen. This is often accompanied by bloating and may be relieved by passing gas or having a bowel movement.

5. Muscle Spasms or Tension: Sometimes, tightness or spasms in the abdominal muscles can create a sensation of a mass. This is often related to stress, physical activity, or underlying conditions like irritable bowel syndrome (IBS).

Given that you have noted changes in the mass's behavior and the onset of discomfort, it is advisable to seek medical evaluation. Here are some reasons why you should consider consulting a healthcare professional:
- Persistent Symptoms: If the mass has changed in size, shape, or sensation, or if you experience new symptoms such as pain, nausea, or changes in bowel habits, it is essential to have these evaluated.

- Physical Examination: A healthcare provider can perform a physical examination to assess the mass's characteristics, such as its size, mobility, and tenderness, which can help in determining the underlying cause.

- Imaging Studies: Depending on the findings from the physical examination, your doctor may recommend imaging studies, such as an ultrasound or CT scan, to get a clearer picture of what is happening inside your abdomen.

- Rule Out Serious Conditions: While many causes of abdominal masses are benign, it is crucial to rule out more serious conditions, such as tumors or significant hernias that may require surgical intervention.

In summary, while it is possible that the movable abdominal mass you are experiencing could be related to benign causes such as gas or muscle tension, the changes you have described warrant further investigation. Consulting with a healthcare provider will help you get a definitive diagnosis and appropriate management. It is always better to err on the side of caution when it comes to changes in your body, especially when they involve new or concerning symptoms.

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