Right Iliac Fossa Mass: A Clinical study

Vimala, G (2016) Right Iliac Fossa Mass: A Clinical study. Masters thesis, Kilpauk Medical College, Chennai.

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Abstract

BACKGROUND AND OBJECTIVE : Mass in the right iliac fossa is a common clinical entity encountered in surgical practice. It is one diagnosis that has a varied range of pathologies and fits in aptly to the description that the abdomen is a pandora’s box. The main intention of this study is to know the varying modes of presentation, different modalities of diagnosis, treatment and management of right iliac fossa mass and to identify factors which can help in better management of these cases. METHODS : Fifty patients presenting to the general surgery department of Govt. Royapettah Hospital and Kilpauk Medical hospital, Chennai with a clinical diagnosis of Right Iliac Fossa Mass were included in the study. Period of Study was from November 2014 to August 2015. Inclusion criteria: Masses in right iliac fossa arising from the appendix, caecum, terminal ileum, retroperitoneal connective tissue and psoas abscesses are included Exclusion criteria: 1. Female patients with pathology related to uterus and its appendages. 2. Right iliac fossa masses secondary to extra-abdominal pathology. 3. Masses from structures which abnormally present in the right iliac fossa. 4. Bony swellings of the region. 5. Patients with right iliac fossa mass who are terminally ill. 6. Children less than 10 years of age. A detailed clinical history was elicited and a careful general physical and systemic examination was carried out along with the necessary investigations. Appropriate management was done Follow up period – 1 month RESULTS : The Data obtained in the study was analysed, and it was found that the male to female ratio was 2.8:1. Most patients were of appendicular pathology. Appendicular mass was seen in 22 patients and appendicular abscess in 6 patients. Appendicular pathology was seen in younger age groups and Carcinoma caecum was common in older group. Patients were also analysed based on clinical parameters, few laboratory investigations and the mode of treatment. The results are published in this study. CONCLUSION : • The highest incidence of mass in the right iliac fossa was seen in 3rd and 4th decade. Most of our patients were of low socio-economic status • Commonest presenting symptoms were pain in right iliac fossa, fever, vomiting, loss of weight • Tenderness was the prominent clinical sign which was elicited in most of these cases. • Appendicular mass was most common cause of RIF mass at our hospital constituting to 44 % of the cases. It is common in 3rd , 4th and 2nd decades of life. Male to female ratio was 19:4 (4.7:1). • In this series ileocaecal tuberculosis formed 18% of cases taken up for study of mass in the right iliac fossa most common only to appendicular mass. • Carcinoma, caecum formed 16% of cases of present study. 75% cases were seen in the age group above 50 years and oldest patient of this study was aged 68 years. • In present study 22% of cases of ileocaecal tuberculosis had associated pulmonary tuberculosis so patients with ileocaecal tuberculosis should be evaluated for chest symptoms and subjected for sputum AFB • USG is the most easily available bed side investigation for RIF mass presenting at our hospital CECT abdomen remains the Gold standard investigation for etiological diagnosis for RIF mass.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Right Iliac Fossa Mass ; Clinical study.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 12 Oct 2017 00:58
Last Modified: 12 Oct 2017 00:58
URI: http://repository-tnmgrmu.ac.in/id/eprint/3539

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