Retroperitoneal Mass: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

General physical examination – including blood pressure, pulse, body weight, height; furthermore:

  • Inspection (viewing).
    • Skin, mucous membranes and sclerae (white part of the eye).
    • Lymph node stations (cervical, axillary, supraclavicular, inguinal) including palpation (palpation).
    • Abdomen (abdomen)
      • Shape of the abdomen?
      • Skin color? Skin texture?
      • Efflorescences (skin changes)?
      • Pulsations? Bowel movements?
      • Visible vessels?
      • Scars? Hernias (fractures)?
    • Genital and anal region
  • Auscultation of the heart
  • Auscultation of the lungs
  • Examination of the abdomen
    • Auscultation of the abdomen [vascular or stenotic sounds?, bowel sounds?]
    • Percussion (tapping) of abdomen (note: solid mass cannot be excluded by resonance (the reason: bowel loops may be pushed forward); ascites (abdominal fluid): flank attenuation):
      • [Ascites: Fluctuation wave phenomenon. This can be triggered as follows: tapping against one flank a wave of fluid is transmitted to the other flank, which can be felt by placing the hand (undulation phenomenon); flank attenuation.
      • Meteorism (flatulence): hypersonoric tapping sound.
      • Attenuation of the tapping sound due to enlarged liver or spleen, tumor, urinary retention?
      • Hepatomegaly (liver enlargement) and/or splenomegaly (spleen enlargement): estimate liver and spleen size.
    • Palpation of the abdomen (tenderness?, tapping pain?, coughing pain?, guarding?, hernial orifices?, renal bed tenderness?).
  • Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation: assessment of the prostate in size, shape and consistency.
  • Gynecological examination – if cervical cancer is suspected.
  • Neurological examination – if neurogenic tumor is suspected.
  • Urological examination – for example, if renal cell carcinoma (renal cell cancer) is suspected.
  • Cancer screening

Square brackets [ ] indicate possible pathological (pathological) physical findings.