A STUDY ON RIGHT ILIAC FOSSA MASS

130 | P a g e A STUDY ON RIGHT ILIAC FOSSA MASS Dr. Pradeep Kumar Verma, Dr. Sanvar Mal Kantva Assistant Professor, 2 Senior Resident 1 Department of General Surgery, S M S Medical College Jaipur 2 Department of General Surgery, S M S Medical College & Attached Group of Hospital, Jaipur Article Info: Received 22 August 2019; Accepted 16 September. 2019 DOI: https://doi.org/10.32553/ijmbs.v3i9.546 Corresponding author: Dr. Sanvar mal kantva Conflict of interest: No conflict of interest.


Introduction:
Mass in the right iliac fossa is not an uncommon entity in the surgical wards, whether detected clinically or as an Ultrasonography finding.Though we think of appendix more commonly in the right iliac fossa there are many other structures giving rise to a mass in the right iliac fossa. 1 Thus preoperative diagnosis remains an enigmatic challenge and a reminder of art of surgical diagnosis.Patients with mass in the right iliac fossa may confront the surgeon, pediatrician or gynecologist.Thus, thorough understandings of the anatomy and pathological process 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.
As the mass in the right iliac fossa is a differential diagnosis, though some investigations are common, some may differ from individual cause and the management is according to the cause. 2,3e objective of this study was to study the etiopathology, clinical presentations of the various pathological entities of mass in the right iliac fossa along with its differential diagnosis and management.All the patients were evaluated as per the proforma.A written and informed consent was taken from the patient after explaining details of treatment modalities.Clinical diagnosis was confirmed by relevant investigations and patient was managed appropriately.After confirming the diagnosis and depending on patient's condition appropriate surgery was performed if necessary.

Data Analysis:
To collect required information from eligible patients a pre-structured pre-tested Proforma was used.For data analysis Microsoft excel and statistical software SPSS was used and data was analyzed with the help of frequencies, figures, proportions, measures of central tendency, appropriate statistical test.

Various conditions
No. of patients

Psoas abscess 6
Others(undiagnosed) 4 Totals 100 In this study of 100 cases 86 % of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess.There were 3 cases of ileocaecal tuberculosis.

Discussion
In present study maximum age incidence was in 3rd decade (32%) followed by 2nd decade (22%).It was more common in males than females.
According to R.C. Nagar et al 4 appendicular mass was more common in 3rd, 4th and 2nd decades of life.Male to female ratio was 19:4 (4.7:1).
In this study of 100 cases 86 % of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess.There were 3 cases of ileocaecal tuberculosis.
According to Barry Foran et al 5 in 61.5% cases they could do appendicectomy and in 15 % they had to go in for right hemicolectomy.
Appendicular abscess patients formed 11% of the present group study.50% of the cases were in 4th decade and in 75% cases males were affected.Most of patients presented within 1 month of symptoms.
According to Edward L Bradley III et al 6 , mean age at which appendicular abscess occurred was 40.7 ± 2.7.Symptoms had been present on an average of 9.2 ± 0.8 days prior to admission.
In appendicular abscess initially pain was colicky and then it progresses to pricking/throbbing type.25% of cases complained of mass per abdomen and it was tender and soft in consistency.Fever was present in 50% cases.According to Hurme T et al 7 , in his study of 147 patients 47% were primarily treated conservatively, of them 9% had to be operated on in acute phase because of worsening of symptom.Rest 53% was operated on primarily of which 28% had complications.In 31 % of conservatively managed patients -interval appendicectomy was done and 12 % were treated conservatively only.
In present study all 12 cases were taken up for immediate extra peritoneal drainage of abscess, which is a preparation for interval appendicectomy done after 6-8 weeks.In all cases Interval appendicectomy was done and histopathology report showed chronic appendicitis.According to Edward L Bradley III et al 6 , 6% of his patients group had wound infection after initial extraperitoneal drainage and after interval appendicectomy wound infection occurred in 9% of his patients.
design: Hospital prospective based study.Study population: All patients with pain in right iliac fossa.Sample size: 100 patients reporting to the Surgery dept.within study duration and eligible as per inclusion criteria will be included in the study.Sampling Method: Random sampling Inclusion Criteria: All the cases that presented during the study period, having a mass in the RIF Patients of both sex Patients who have also been found to have a mass in the RIF incidentally on examination and investigations are included in the study.Exclusion Criteria: Patients having a mass in the right iliac fossa due to gynaecological conditions are excluded Data Collection: