Clinical Evaluation and Surgical Management of Abdominopelvic Masses in Children

Abstract

Objective: To assess the demographic details and clinical profile of children with abdominopelvic mass and determine the features of benign and malignant pathologies in children.

Methodology: Prospective descriptive study was conducted at Paediatric surgery department, from January 2024 to July 2025. A total of hundred (100) patients of age 12 years or less, presenting with a palpable abdominal or pelvic mass or mass found on imaging, were included in the study and their demographic and clinical details were taken. Data was analyzed on SPSS. Categorical data was expressed in frequencies and percentages. Quantitative data was expressed in means and standard deviation.

Results: Out of 100 patients with abdominal mass, 59 (59%) were males and 41 (41%) were females. The most common age group was 1-5 years of age 42 (42%). Sixty-eight (68%) were admitted from OPD and 32 (32%) from ER. The most common chief complaint was abdominal swelling or mass 45 (45%) followed by abdominal pain 40 (40%). Intraperitoneal, retroperitoneal and pelvic masses were 45 (45%), 41 (41%), 13 (13%) respectively. Sixty (60%) of the masses were benign and 40 (40%) were malignant. Out of the 60 benign palpable masses, 15 (25%) were pseudo masses. The most common system involved was Gastrointestinal 40 (40%) followed by Urinary system 25 (25%). The most common abdominal masses were Wilm tumor 17 (17%), ovarian tumors/cyst 12 (12%), mesenteric cyst 9(9%), and NHL/Burkitt lymphoma 6(6%). In 20 patients, diagnostic discordance between preoperative and intraoperative findings was observed.

Conclusion Abdominopelvic mass warrants detailed history and examination. Intraabdominal malignancy may have an acute presentation and intraoperative findings may be different to the initial preoperative diagnosis. For a pediatric surgeon, a thorough clinical assessment, broad differentials, and surgical preparedness are key to optimal management.