oa South African Medical Journal - Large abdominal swellings in childhood : a report on 28 consecutive cases



Twenty-eight cases of children under 11 years of age, who presented with symptomless and large abdominal swellings, have been discussed. The swellings were found in every quadrant of the� abdomen. They were situated in the abdominal wall, intraperitoneally and retroperitoneally, but the majority (16 cases) occupied the loins, were extraperitoneal and either arose from the kidneys or were clinically indistinguishable from renal swellings. Among the latter were two large retroperitoneal abscesses and a tremendous choledochal cyst. Thirteen of the swellings had their origin in some part of the urinary system. The cases could be classified into 4 groups, viz. congenital (9), inflammatory (4), neoplastic (13) and hydatid disease (2). The congenital group included 6 anomalies of the urinary system, a mesenteric cyst, a retroperitoneal cyst, and an unusual case of a choledochal cyst in a girl who had never been jaundiced. The inflammatory group included 4 cases with low-grade abscesses, 2 of which were retroperitoneal. All the swellings encountered in infants less than 3 months old were due to congenital anomalies. Three out of every 4 swellings in the age-group 11 months to 5 years were malignant neoplasms. In children aged 6 to 10 years, most of the swellings were benign cysts and no malignant tumours were found. The most striking feature about the series was the high incidence of neoplastic disease.


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