A Study of Mass in Right Iliac Fossa: A Retrospective study

INTRODUCTION: Mass in the abdomen, by reason of their wide spread implications, has since long exercised the minds of many workers. Mass in the right iliac fossa is not an uncommon entity. Patient with mass in the right iliac fossa may present to the surgeon, pediatrician, obstetrician and gynecologist. A thorough understanding of the anatomy and pathological processes that may occur within the abdomen are essential for an accurate diagnosis and plan of treatment. Some patients will require immediate surgical intervention, whereas others will improve with conservative treatment. The purpose of the present study is to recognize certain well defined clinicopathological entities and the relative incidence of various pathologies, who presented with mass in right iliac fossa to STANLEY MEDICAL COLLEGE AND HOSPITAL over the last 1 year from August 2015 to August 2016 in the overall endeavor to reduce morbidity and in few instances mortality. OBSTRUCTION: 1. To study various diseases which can present as mass in RIF in adults and their relative incidence. 2. To study the age and sex distribution of various diseases. 3. To study disease causing obstruction. 4. To study diseases causing fistula formation. 5. To study the diseases causing disorders of bladder function. METHODOLOGY: This is a study of cases with RIF mass who presented to Stanley govt medical college and Hospital between August 2015 and August 2016 over a span of 1 year. The case sheets of patients diagnosed as having RIF mass based on clinical signs backed up by radiological evidence and operative findings were taken from the medical records department for the study. The relevant history and clinical findings of each case were noted in the proforma. Female patients with pathologies related to uterus and its appendages were not included in this study. Similarly masses arising from parietes (anterior abdominal wall) and bone in that region were not included in this study. RESULTS AND DISCUSSION: 1. Incidence of Various Condition: In this study of 50 cases, appendicular mass being the most common more than75% of cases. 2. Age Incidence: In this study, youngest patient was of age 13 years, who presented with appendicular mass and oldest was 75 years were to be the same appendicular mass. Appendicular mass manifested most common in the 2nd decade covering upto 33% of cases of appendicular mass. Ileocaecal tuberculosis were most common in the 3rd decade. Psoas abscess were most common in the 1st decade. Carcinoma caecum common in 3rd decade in my study. 3. Sex Incidence: In my study, appendicular mass is more common in males of about 72%. Appendicular abscess, ileocaecal tuberculosis and psoas abscess were of equal incidence in both male and females. Carcinoma caecum only case present in male. Male and female ratio is 2.5:1. 4. Disease Presented with Intestinal Obstruction: In my study 5% of patients with appendicular mass presented with intestinal obstruction. 50% of ileocaecal TB cases presented with intestinal obstruction. Overall 6% of right iliac fossa mass presents with intestinal obstruction. 5. Diseases complicated by EC fistula: In my study 4% of overall population complicated with enterocutaneous fistula. Out of which 2.6% patients of appendicular mass complicated by enterocutaneous fistula. 50% of patients with ileocaecal TB complicated by enterocutaneous fistula in my study. 6. Diseases Causing Bladder Dysfunction: In my study 50% of appendicular mass patient present with bladder dysfunction, of which 28% being dysuria. Patient age above 70 years of age present with acute retention of urine associated RIF MASS. CONCLUSION: 1. A study of 50 cases of mass in right iliac fossa, who were admitted to Govt.Stanley medical college during the period from august – 2015 to august 2016 was made. 2. Males were affected more and M: F ratio was 2.5:1. 3. All the cases in this study were subjected to radiological investigations like USG and C.T. abdomen. Most of the clinical diagnosis could be confirmed by USG studies and in few cases patients were subjected to C.T. abdomen diagnosis. This shows that USG can diagnose most of the conditions presenting as right iliac fossa mass. 4. Most of the cases presenting with mass in the right iliac fossa were managed surgically which turned out to be the most effective management while very few cases were managed conservatively. 5. Appendicular pathology either in the form of appendicular mass or appendicular abscess was the most common condition presenting as mass in the right iliac fossa closely followed by ileocaecal tuberculosis, psoas abscess and carcinoma caecum.