Evidence based diagnostic protocol and management for pain in right iliac fossa

Abstract

Background: Right iliac fossa pain is most common clinical presentation encountered in surgical OPD. Usually during evaluation, diagnosis is uncertain in some cases and patient suffers a lot. Clinical symptoms usually not involved during evaluation of patient this also makes diagnosis more difficult. Therefore, aim of the study was that how we would proceed in this case. Methods: This was prospective study and total 30 patients were analyzed. Study was done at tertiary centre. All patients suspected with pain in right iliac fossa included in this study. First evaluated clinically then biochemical and radiological investigated. Histological and acid-fast bacilli culture was not included. Results: Out of 30 cases, acute appendicitis were in 15 cases (50%), followed by appendicular lump (7 cases, 23%), irritable bowel disease (3 cases, 10%), tubercular lesion (2 cases, 6.7%), carcinoma of caecum (1 case, 3.33%), appendicular abscess (1 case, 3.33%), both appendicitis with tubercular lesion were also present (1 case, 3.33%). All cases of acute appendicitis, appendicular lump, carcinoma of caecum were managed surgically while appendicular abscess and ilieocaecal tuberculosis was managed conservatively. Conclusions: The diagnosis of right iliac fossa pain is very difficult. Be very cautious during clinical evaluation. Even if CT scan is still unclear about the diagnosis and till date no definite diagnostic protocol has made. Before validate this protocol, a large data must be needed.