Views And Reviews

The tip of the iceberg

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6960.1025 (Published 15 October 1994) Cite this as: BMJ 1994;309:1025
  1. A McCartney

    I palpated a lump in my epigastrium nine months to the day after delivering my third child when I was 43. I was not alarmed since I had had an easy pregnancy and returned to work two months later as a consultant pathologist. I felt well. True, I was tired, but who is not with a full time job and three children, especially a small baby who still woke me five or six times a night. I was fatter than I liked but I had not visited the gym very often to tighten the rectus muscles which had separated. Mild epigastric pain could be easily accounted for by snatched lunches.

    I persuaded my husband's senior partner of my health and my diagnosis, of which I was rather proud, of a desmoid tumour in the upper rectus. Since we have a specialised soft tissue unit at St Thomas's Hospital I asked him to refer me. The soft tissue surgeon felt it and told me that the lump was not in the abdominal wall but in the liver. I went upstairs to my office clutching my plain abdominal x ray film and thought of all the benign causes of enlarged liver after pregnancy.

    The scanning staff were rather evasive, murmuring about a diffuse …

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