Abdominal Masses in the Newborn

Abstract

The presence of an abdominal mass in the neonatal period is common, occurring in approximately 1 infant in 1000 live births. Despite this relatively high incidence, the finding of an abdominal mass in a neonate can be alarming for both parents and physicians. Until recently, the identification of an abdominal mass was made by physical signs (ie, abdominal distention, palpable mass). However, in the past decade, fetal ultrasound has become technically refined and is more widely practiced. As a result, the presence of an abdominal mass in the fetus may be known long before birth, allowing for the formation of a specific diagnosis and treatment plan. In addition to fetal ultrasonography, a wide array of sophisticated imaging techniques have become available to aid in the diagnosis of an abdominal mass. However, in the cost-conscious environment in which health care must be provided, it is the physician's responsibility to evaluate an abdominal mass as cost effectively as possible. Early consultation among the pediatrician, pediatric radiologist, pediatric surgeon, and, in the case of prenatal diagnosis, the obstetrician can expedite this process. Many abdominal masses are of the nonsurgical variety (ie, organomegaly or bladder distention). Most masses requiring surgical intervention are benign (87%), and the prognosis for neonates with an abdominal mass is good.