A lump in the abdomen is a soft bulge of tissue or a small, local area of swelling in the belly area.

See also: Abdominal mass

Abdominal hernia; Hernia - abdominal; Abdominal wall defects; Lump in the abdominal wall; Abdominal wall mass

Most often, a lump in the abdomen is caused by a hernia. An abdominal hernia occurs when there is an area where the muscles are weak. This allows the internal organs to bulge through the abdominal wall. A hernia may not appear until after you strain, lift something heavy, or have a prolonged 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 doesn't close completely.

Other causes of the lump in the abdominal wall include:

• Hematoma (collection of blood under the skin after trauma)
• Lymph nodes
• Lipoma (collection of fatty tissue under the skin)
• Undescended testicle
• Tumor of the skin or muscles

Seek appropriate care for chronic cough or constipation if you have a hernia. Straining associated with these conditions causes the intestines to bulge further into the hernia.

Call your doctor if you have a lump in your abdomen that becomes larger, discolored, or painful.

If you have a hernia, call your doctor if you have:

• Fever
• Vomiting
• Abnormal appearance of the hernia
• Pain or tenderness around the hernia

A strangulated hernia (when the blood supply to the organs that protrude through the hernia is lost) is very rare, but it is a medical emergency.

The doctor 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?
• How large is the abdominal lump? Try to measure the diameter (distance across) or compare it to another object (the size of a baseball, for example)
• Does anything make the lump bigger or smaller?
• What other symptoms do you have?

During the physical examination, you may be asked to cough or strain.

Surgery may be needed to correct incisional hernias or umbilical hernias that do not go away by the time the child approaches school age. Emergency surgery is needed in the case of a strangulated hernia.

Malangoni MA, Rosen MJ. Hernias. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 44.

Turnage RH, Richardson KA, Li BD, McDonald JC. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 43.