Lump in the abdomen
Abdominal hernia; Hernia - abdominal; Abdominal wall defects; Lump in the abdominal wall; Abdominal wall mass
A lump in the abdomen is a small area of swelling or bulge of tissue in the belly.
Causes
Most often, a lump in the abdomen is caused by a hernia. An abdominal hernia occurs when there is a weak spot in the abdominal wall. This allows the internal organs to bulge through the muscles of the abdomen. A hernia may appear after you strain, or lift something heavy, or after a long period of coughing.
There are several types of hernias, based on where they occur:
- Inguinal hernia appears as a bulge in the groin or scrotum. This type is more common in men than women.
- Incisional hernia can occur through a scar if you have had abdominal surgery.
- Umbilical hernia appears as a bulge around the belly button. It occurs when the muscle around the navel does not close completely.
Other causes of a lump in the abdominal wall include:
- Hematoma (collection of blood under the skin after injury)
- Lipoma (collection of fatty tissue under the skin)
- Lymph nodes
- Tumor of the skin or muscles
You're lifting a heavy box, when suddenly, you feel a strain in your stomach or groin. If you also feel a bulge there, you might have a hernia. The bump that you feel is a part of what's in your abdomen bulging out through a weak spot in the muscle or tissue that surrounds it. A hernia is kind of like pushing your finger against the side of a balloon. What type of hernia you have depends on where the bulge is located. A femoral hernia is a bulge in the upper part of your thigh. A hiatal hernia is located in the top part of your stomach. An umbilical hernia bulges around your belly button. Inguinal hernias are in the groin area. And incisional hernias usually form around a scar from a past surgery in your abdomen. You can get a hernia if you lift something that's too heavy, or strain too hard while coughing, urinating, or having a bowel movement. Sometimes babies are born with a hernia. That happens when the lining that is supposed to hold the abdominal organs doesn't totally close before birth. Some hernias don't cause any symptoms. You might live with a hernia for a while without even noticing that you have it. Or, you may see an actual bulge in your leg, stomach, or groin. Hernias can sometimes be painful, especially when you strain or lift something heavy. Your doctor should be able to locate the hernia during an exam. If your hernia is small and doesn't bother you, you may not need to do anything but keep in touch with your doctor to make sure it isn't growing. If the hernia is big or painful, your doctor may recommend surgery to plug the opening. The one big risk to having a hernia is that with some types the tissue can get caught inside the hole. This is called strangulation. It can be very dangerous, because blood is cut off to the part of the organ that's trapped. Eventually that tissue will die. If you have a strangulated hernia, you'll need to have emergency surgery. Surgery is the only way to reverse a hernia, although in young children umbilical hernias will often go away on their own. If you have a small hernia and decide not to have surgery, be on the lookout for any changes. Call the doctor right away if you have pain, nausea, vomiting, or a fever, or if your hernia turns red, purple, or another color. These could be signs of strangulation. To avoid a hernia in the first place, be careful when lifting heavy objects. Drink plenty of fluids and add fiber to your diet so you won't have to push too hard on the toilet. And see a urologist if you're straining while urinating.
When to Contact a Medical Professional
Contact your health care provider if you have a lump in your abdomen, especially if it becomes larger, changes color, or is painful.
If you have a hernia, contact your provider if:
- Your hernia changes in appearance.
- Your hernia is causing more pain.
- You have stopped passing gas or feel bloated.
- You have a fever.
- There is pain or tenderness around the hernia.
- You have vomiting or nausea.
The blood supply may be cut off to the organs that stick out through the hernia. This is called a strangulated hernia. This condition is very rare, but it is a medical emergency when it occurs.
What to Expect at Your Office Visit
Your provider will examine you and ask questions about your medical history and symptoms, such as:
- Where is the lump located?
- When did you first notice the lump in your abdomen?
- Is it always there, or does it come and go?
- Does anything make the lump bigger or smaller?
- What other symptoms do you have?
During the physical exam, you may be asked to cough or strain.
Surgery may be needed to correct hernias that do not go away or cause symptoms. The surgery may be done through a large surgical cut, or through a smaller cut into which the surgeon inserts a camera and other instruments.
References
Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Abdomen. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 18.
Privratsky AM, Barreto JC, Turnage RH. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 44.
Version Info
Last reviewed on: 9/9/2023
Reviewed by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
