Why Do I Feel a Lump in the Middle of My Stomach When Lying Down?

If you feel a lump in the middle of your abdomen while lying down, several possibilities might explain this sensation. One common cause is an abdominal wall hernia, such as a Spigelian hernia. This occurs when internal tissue pushes through a defect in the abdominal wall, and the lump might become more noticeable in a relaxed position. Another possibility is an abdominal hematoma, which is a collection of blood within the abdominal tissues that can form as a result of trauma or even spontaneously in some cases. Depending on its size and location, it can present as a palpable lump. Rarely, a tender, pulsatile mass in this area might raise concern for vascular issues like an abdominal aortic aneurysm, although these are typically located more centrally and can be distinguished by other clinical features. These lumps can range from benign conditions to those that require prompt treatment. As a result, any new or persistent lump should be evaluated by a healthcare provider. They will perform a physical examination and likely order imaging studies (such as an ultrasound or CT scan) to determine the cause and recommend the appropriate management.