Right iliac fossa mass
Approach
- Abdominal examination
- Inspect
- Hands - clubbing (IBD), pale skin creases (anaemia, chronic bleeds), AV fistula (Transplanted kidney)
- Eyes - pale conjunctivae (anaemia), sclera (jaundice)
- Neck - Lymphadenopathy: esp note presence of Virchow's node in left supraclavicular fossa
- Abdomen - Scars from previous surgery, asymmetry
- Palpate
- Size
- Edge - well defined / poorly defined
- Surface - smooth / irregular / nodular
- Relations - arise from pelvis
- Attachment to skin
- Attachment to abdominal wall muscles
- Percuss
- Ascultate
Completion
- Further examination depends on diagnosis
Differential diagnoses
- skin and soft tissues
- sebaceous cyst
- lipoma
- sarcoma
- bowel
- carcinoma of caecum
- crohn's mass
- TB of terminal ileum
- Appendicular mass / abscess
- gynaecological
- ovarian tumours
- fibroid uterus
- male reproductive system
- undescended testis
- ectopic testis
- urological system
- transplanted kidney
- ectopic kidney
- bladder diverticulum
- blood vessels
- external iliac or common ilaic artery aneurysm
- lymphadenopathy
Investigations of RIF mass
- USS: distinguish bowel, ovarian, uterine, nodes, blood vessels
- CT / contrast enhanced CT
