What does a minimally tender smooth lower abdominal mass with dullness to percussion likely represent in an 84-year-old?

A minimally tender smooth lower abdominal mass with dullness to percussion in an 84-year-old is most consistent with an enlarged bladder. Dullness to percussion typically indicates fluid or a solid mass in the abdomen, and in the aging population, the bladder can become distended, particularly if there are underlying issues such as urinary retention or bladder obstruction. An enlarged bladder may also present as a smooth mass that is typically non-tender unless there is acute distress or infection.

In elderly patients, it’s essential to consider conditions that impact bladder function, such as benign prostatic hyperplasia or other urological conditions that can lead to an enlarged bladder. The smooth nature of the mass suggests it is likely not of a malignant origin, which aligns with the characteristics of a distended bladder.

Other possibilities, such as an enlarged spleen or a colon mass, would typically present with different features. An enlarged spleen often has accompanying tenderness or is difficult to palpate smoothly depending on the underlying pathology. A colon mass would likely present with irregularities and could potentially have associated symptoms like changes in bowel habits or pain. Additionally, the term "pretend abdominal mass" is not a recognized clinical condition and does not apply to this scenario.

Thus, the