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A. Epigastrium

  1. Gastric Cancer
  2. Gastric Ulcer (perforation and scarring)
  3. Esophageal Carcinoma with direct spread

B. Right Upper Quadrant

  1. Hepatoma
  2. Hepatic Cyst
  3. Tumor of the Gall Bladder / Periampullary Carcinoma
  4. Primary Small Intestinal Tumor

C. Left Upper Quadrant

  1. Splenosis
  2. Pancreatic Carcinoma (spread)

D. Right Lower Quadrant

  1. Appendicitis (perforation with scarring)
  2. Colonic Polyps
  3. Colon Carcinoma
  4. Cecitis - usually secondary to Crohn's Disease

E. Left Lower Quadrant

  1. Diverticulitis
  2. Diverticulosis
  3. Colon Carcinoma

F. Retroperitoneal

  1. Primary Tumors of Retroperitoneum
    1. Sarcomas
    2. Neuroendocrine tumors - neurofibroma, ganglioneuroma, pheochromocytoma
    3. Lymphomas
    4. Diffuse retroperitoneal carcinomas (undifferentiated and metastatic)
    5. Chordomas
  2. Retroperitoenal Fibrosis
    1. Primary (idiopathic) - about 70% of cases
    2. Secondary (listed below)
    3. Drugs - methysergide, methyldopa, ergot alkyloids
    4. Periarteritis - usually with aortic aneurysm
    5. Malignant tumors
    6. Radiation fibrosis
    7. Infection - intrabdominal, gonorrhea, abscess
    8. Lymphangitis
    9. Retroperitoneal Hemorrhage (often after invasive proceedure)
    10. Connective Tissue / Autoimmune Disease - systemic sclerosis, systemic lupus
    11. Granulomatous Disease - tuberculosis, sarcoidosis
    12. Biliary Tract Disease - including primary biliary cirrhosis, sclerosing cholangitis

G. Kidney Associated

  1. Renal Carcinoma
  2. Renal Cysts - including polycystic kidney disease
  3. Adrenal Mass (see below)
  4. Pheochromocytoma
  5. Metastatic Disease

H. Bilateral Adrenal Mass [1]

  1. Metastatic Disease
    1. Lung carcinoma
    2. Breast carcinoma
    3. Renal malignant tumor
    4. Melanoma
    5. Colon cancer (rare)
  2. Primary Tumor
    1. Lymphoma
    2. Pheochromocytoma
    3. Adrenocortical carcinoma
    4. Neuroblastoma (pediatric)
  3. Adrenal Hyperplasia (Endocrinopathy)
    1. Corticotropin-dependent Cushing's Syndrome
    2. Cushing's Disease (pituitary tumor)
    3. Ectopic corticotropin section
    4. Benign pheochromocytoma
  4. Infectious Disease
    1. Tuberculosis
    2. Fungal - histoplasmosis, blastomycosis, coccidiomycosis, cryptococcosis
  5. Miscellaneous
    1. Incidental adrenal tumors
    2. Myelolipoma
    3. Hemorrhage
    4. Amyloidosis

I. Peritoneal

  1. Abscess
  2. Lymphoma
  3. Peritoneal Carcinomatosis
  4. Pelvic Neoplastm

References

  1. Udelsman R and Dong HY. 2000. NEJM. 343(20):1477 (Case Record)