Investigation Plan for Abdominal Mass

Publication: 20/03/2012  
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.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

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)

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.

Reference to other Guidelines if applicable

None

Contact Details for the document

r.phillips2@nhs.net

Description of Target Patient Group

All patients referred to Leeds Regional Haematology/Oncology service with a diagnosis of suspected leukaemia

Description of Target Staff Group

Medical and nursing staff in Leeds Regional Haematology/Oncology service

Measurable Outcomes

1 – Adherence to blood taking policy
2 – Adherence to radiology policy

Clinical or Non-Clinical Risk of Non-Compliance:

Delay in diagnosis
Failure to confirm underlying viral serology and potential for repeated unnecessary administrations of Zoster Immunoglobulin
Unsafe anaesthetic secondary to mediastinal obstruction

Clinical or Non-Clinical Risk of Compliance:

Bruising

Evidence Base:

PHITT, WT-2001/Import, HR-NBL-1
Local audit of EBM/CMV prevalence

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Suspected Malignant Abdominal Mass Initial Investigations Flowsheet

Investigation

Tube(s)

Initials/date sent

Full blood count & film
(ESR if Hodgkin suspected)

EDTA (purple top)

 

Coagulation profile

Citrate (light blue top)

 

Electrolytes, urea, creatinine, calcium, phosphate, magnesium, LFTs, urate and LDH

Li-Heparin (green top)

 

Group & save

EDTA (purple top)

 

Serology: VZV, EBV, CMV, HSV, Hepatitis, HIV if lymphoma strongly suspected

Clotted (red top)

 

PCR: EBV/CMV

EDTA (purple top)

 

Alpha-fetoprotein (AFP) & beta-HCG

Serum gel (gold top)
to biochemistry

 

Ferritin

Serum gel (gold top)
to haematology

 

Vitamin D / PTH

Li-Heparin (green top)

 

Tanner stage

 

 

Height & Weight

Tape measure & scales

 

Performance status

 

 

Urine:

Spot urine catecholamines

SPECIAL ACIDIFIED container

 

Imaging:

Investigation

Undertaken? Appointment?

Initials/date sent

Chest radiograph

 

 

Abdominal ultrasound

 

 

Further imaging (eg CT-Chest/Abdomen/Pelvis)
as clinically required

 

 

 

 

Discussed

Date

Line insertion (specify type)

 

 

Pregnancy test (if required)

 

 

Fertility preservation discussion (if required)

 

 

Dental review (fax)

 

 

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

Equity and Diversity

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