​Differential Diagnosis of Abdominal Wall Masses

​Differential Diagnosis of Abdominal Wall Masses
• Umbilical hernia : The hernia is through the umbilical scar. Those presenting at birth commonly resolve in the first years of life.
• Tumor nodule of the umbilicus (secondary to intraperitoneal malignant neoplasm, also called Sister Mary Joseph nodule)
• Supraumbilical elliptical swelling of attenuated linea alba (no cough impulse)
• Spigelian hernia : A rare hernia found along the linea semilunaris at the lateral edge of the rectus sheath, most commonly a third of the way between the umbilicus and the pubis.
• Sebaceous cyst
• Rectus sheath hematoma (usually painful)
• Paraumbilical: hernia  The neck is just lateral to the umbilical scar.
• Lipoma
• Incisional hernia: It has an overlying scar. The sac may be very much larger than the neck of the hernia.
• Epigastric hernia : It occurs in the midline between the xiphoid process and the umbilicus. They are usually small (<2 cm). They result when a knuckle of extraperitoneal fat extrudes through a small defect in the linea alba. Commonly irreducible and without an expansile cough impulse 
• Desmoid tumor (associated with Gardner’s syndrome)