Investigation Plan for Abdominal Mass |
| Publication: 20/03/2012 -- |
| Last review: 04/03/2021 |
| Next review: 04/03/2024 |
| Clinical Guideline |
| CURRENT |
| ID: 2887 |
| Approved By: Children and Young Peoples Oncology / Haematology Guideline Development Group & HYC/Y Childrens Cancer Network Guidelines Development Group |
| Copyright© Leeds Teaching Hospitals NHS Trust 2021 |
This Clinical Guideline is intended for use by healthcare professionals within Leeds unless otherwise stated. |
Investigation Plan for Abdominal Mass
Full history and examination should be undertaken, including 3 generations of family history, clinical chickenpox exposure and birth history. Family history of chickenpox exposure should also be assessed: non-immune family members are advised to be vaccinated if chickenpox negative index patient and chemotherapy is to be given [HPA 2006]
If patient is female and has started menarche, pregnancy test will be required. Please see pregnancy test SOP.
Fertility preservation may be offered to patients, depending on the risk of fertility impairment. Please refer to CCLG Fertility Preservation guidance
Please see appendix 1 for relevant investigations; these are the ‘best guess’ for common abdominal malignant masses and could be supplemented by more specific ones when a diagnosis is reached (see New Patient Investigations guideline: ID 2885)
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Statement of Intent – Description of intended Health Benefits if applicable |
To clearly collect important baseline information for ongoing diagnosis and therapy of children and young adults with a suspected malignant process in the abdomen. |
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Reference to other Guidelines if applicable |
None |
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Contact Details for the document |
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Description of Target Patient Group |
All patients referred to Leeds Regional Haematology/Oncology service with a diagnosis of suspected leukaemia |
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Description of Target Staff Group |
Medical and nursing staff in Leeds Regional Haematology/Oncology service |
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Measurable Outcomes |
1 – Adherence to blood taking policy |
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Clinical or Non-Clinical Risk of Non-Compliance: |
Delay in diagnosis |
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Clinical or Non-Clinical Risk of Compliance: |
Bruising |
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Evidence Base: |
PHITT, WT-2001/Import, HR-NBL-1 |
Suspected Malignant Abdominal Mass Initial Investigations Flowsheet
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Investigation |
Tube(s) |
Initials/date sent |
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Full blood count & film |
EDTA (purple top) |
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Coagulation profile |
Citrate (light blue top) |
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Electrolytes, urea, creatinine, calcium, phosphate, magnesium, LFTs, urate and LDH |
Li-Heparin (green top) |
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Group & save |
EDTA (purple top) |
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Serology: VZV, EBV, CMV, HSV, Hepatitis, HIV if lymphoma strongly suspected |
Clotted (red top) |
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PCR: EBV/CMV |
EDTA (purple top) |
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Alpha-fetoprotein (AFP) & beta-HCG |
Serum gel (gold top) |
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Ferritin |
Serum gel (gold top) |
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Vitamin D / PTH |
Li-Heparin (green top) |
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Tanner stage |
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Height & Weight |
Tape measure & scales |
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Performance status |
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Urine:
| Spot urine catecholamines |
SPECIAL ACIDIFIED container |
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Imaging:
| Investigation |
Undertaken? Appointment? |
Initials/date sent |
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Chest radiograph |
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Abdominal ultrasound |
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Further imaging (eg CT-Chest/Abdomen/Pelvis) |
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Discussed |
Date |
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Line insertion (specify type) |
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Pregnancy test (if required) |
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Fertility preservation discussion (if required) |
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Dental review (fax) |
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Provenance
| Record: | 2887 |
| Objective: | To outline the acute investigations to be undertaken when children and young people present with a possibly malignant abdominal mass |
| Clinical condition: | Suspected maligancy in children and young people |
| Target patient group: | Children and Young People with Malignancy |
| Target professional group(s): | Secondary Care Doctors |
| Adapted from: |
Evidence base
HPA. Immunisation against infectious disease - 'The Green Book'. Chapter 34: Varicella. http://www.dh.gov.uk/en/Publichealth/Healthprotection/Immunisation/Greenbook/DH_4097254
Approved By
Children and Young Peoples Oncology / Haematology Guideline Development Group & HYC/Y Childrens Cancer Network Guidelines Development Group
Document history
LHP version 1.0
Related information
Not supplied
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