A 10-year-old girl presents with a mass in lower abdomen involving umbilical and the hypogastrium. On examination it is cystic and mobile and the examiner is unable to insinuate fingers between the mass and the pelvic bone. What is the likely diagnosis?
Duplication of small intestine
Omental cyst
Ovarian cyst
Mesenteric cyst
Ans: C. Ovarian cyst(Ref Shaw 16/e p83, 448, 15/e p79, 385)* Accoording to examination, swelling is typically arising from pelvis & hand cannot be insinuated between mass & pelvic bone.* Best option is only ovarian cyst arises from pelvis.* Swellings arising from pelvis - Identified by abdominal palpation. - Sensitive ulnar border of left hand - Used from above downwards to palpate swellings arising from pelvis. - Upper & lateral margins felt. - Lower border unreached, i.e. the hand cannot be insinuated between mass & pelvis.