Abstract: Back ground and Objectives:
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. The temple of surprises, pandoras box- hackeyened phraseology is apt in case of mass In the right iliac fossa.
This challenging task of recognising certain well defined clinicopathological aspects of mass in the right iliac fossa has stimulated in undertaking this study. Ultrasound is quick, non invasive and has bridged the gap between palpation and direct visualization. In this common clinical condition often disparity between clinical, ultrasound, and final diagnosis. The role of ultrasound in evaluation is necessary as some require emergency surgical intervention and some improve with conservative management.
Materials and Methods: Retrospective study of 42 patients presented with clinical diagnosis of right iliac fossa mass were selected. Pediatric age group, gynaecological conditions, and parietal wall swellings were excluded. In these cases ultrasound examination by 5 and 7.5 Mh ransducers were used and clinical, ultrasound and final diagnosis ware compared.
Results: Appendicular mass constituted 14 cases (33%), appendicular abscess 11cases (26%) leocaecal tuberculosis 8 cases (19%) carcinoma cecum 5 cases (12%) and crohn's disease 1 case (3%). Appendicular mass common in the age group 30-39 years, appendicular abscess in 60- 70 years, Ileocecal tuberculosis in 30-39 years, carcinoma caecum in > 40years, and 1 case of crohns disease between 40-49 years. Ultrasound was able to diagnose appendicular abscess which were clinically diagnosed as appendicular mass. ultrasound was able to find out the bowel thickening with target sign and pseudo kidney sign in Ileocecal tuberculosis. and Carcinoma cecum with moderate specificity.
Conclusion: Appendicular pathology constituted 59% cases. it was able to detect appendicular abscess with high sensitivity and specificity. It helped in early assessment and early intervention of the required, reduces the cost and morbidity, It is an adjuvant diagnostic tool in cases of Ileocecal tuberculosis and carcinoma cecum. In the elderly who cannot withstand and in cases of misleading presentation it has a ole and it is really cost effective, non invasive procedure done in OPD set up without preparation with good result, is a first good line of investigation modality in right iliac ossa mass.