It is rather unusual to have masses in all quadrants -
Tenderness in all quadrants? - this suggests generalised peritonitis
. It will be difficult at this time to localise.
Perforated viscus is highly probable.
In certain countries, Familial Mediterranean Fever
is a priority.
Whatever it may be, the approach should be immediate admission, repeated clinical assessment, blood tests, scans, second opinion
. It sounds serious. It may need laparatomy at any time.
Don't delay / Take care