ROLE OF USG AND CT SCAN IN EVALUATION OF RIGHT ILIAC FOSSA MASS

Jimit R. Sheth, Darshan R. Shah, C. Raychaudhuri

Abstract


Right iliac fossa(RIF) is considered 'Temple of surprises' as various pathologies of different organs occur here. Imaging has proven to be pivotal in
the diagnostic workup of such patients. USG is the initial screening modality of choice as it is quick, inexpensive & does not carry risk of radiation.
Though it identifies the pathology in right iliac fossa, it cannot accurately find the organ of origin & its impact on adjacent structures. High
resolution multidetector CT scan provides rapid image acquisition in multiple planes in a short period of time and thus shows the exact location of
the lesion but it has a major drawback of radiation.
METHOD: Total 87 patients presenting with right iliac fossa mass were evaluated. All patients were subjected to USG & CT scan. Diagnosis was
made based on USG & CT features and also using clinical correlation.
RESULTS: 42 patients (48.3%) were males and 45 (51.7%) were females. The age of the patients ranged from 6 years to 78 years. The most
number of cases were of gynecological origin accounting for 26.4% cases in females and appendicular origin accounting for 23.8% in males.
Diagnosis was made easy by categorizing the lesions into extraperitoneal & intraperitoneal according to location and neoplastic, infective,
inflammatory, traumatic & nonspecific according to etiopathology.
CONCLUSION: USG is modality of choice for superficial lesions such as undescended testes, foreign body, incisional hernia, cysticercosis and
lymph nodes. CT scan is more sensitive than USG for rest of the lesions such as appendicular pathologies, bowel pathologies, gynaecological
lesions, psoas abscess and lesions extending to RIF; however, CT should be used judiciously due to radiation risk and should be avoided in children
unless necessary.


Keywords


Right iliac fossa, USG, CT scan,

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