Some MRCP candidates find every short case of the abdomen difficult, while ‘a difficult abdomen’ may be presented deliberately as a short case in the examination. In either event, a candidate needs a comprehensive examination routine and some knowledge of difficult clinical conditions likely to prove confounding in the examination setting. Based upon the experience of several hundred candidates, we have highlighted some of the difficult areas, and have sought the help of two gastroenterologists to formulate an approach that avoids various possible pitfalls. This tutorial presents the differential diagnosis of a mass in the abdomen, how to set about solving a diagnostic problem when there is a lot to see but nothing to palpate, and how to overcome the difficulties of being presented with an abdomen where there is neither anything to see nor to palpate.
Dr M Afzal Mir, Senior Lecturer and Consultant Physician, UHW, Cardiff.
Back
