Spectrum of right iliac fossa mass differential diagnosis and their management

Background: Right iliac fossa mass is a common clinical entity encountered in routine surgical practice. The mass arises from different anatomical structures with varied aetiologies that require a high clinical suspicion in its management. The reason being that the mass may range from being benign to most aggressively malignant lesion which encompasses various specialities of surgery like genitourinary, vascular, gynaecological and colorectal surgery.Methods: This was a prospective observational study conducted between august 2015 and October 2017 in Narayan Medical College and Hospital, Nellore. 50 cases were studied after detailed history and physical examination, relevant investigations were done, and different surgical procedures done were noted and histopathological examination of resected specimens was done.Results: In this series out of 50 patients studied, 23 patients (46%) were diagnosed to have appendicular mass, 10 cases (20%) ileocaecal TB, 8 cases (16%), appendicular abscess, 6 cases (12%) CA Caecum, 3 cases (6%) psoas abscess. Most commonly encountered in 3rd decade of life with male predominance.Conclusions: RIF mass is a challenging clinical scenario for the surgeons. Keeping in mind the various differential diagnosis with good clinical acumen supported by appropriate investigations, patients with RIF mass can be managed appropriately either by conservative or surgical management.

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Clinicopathological study of sinonasal masses

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v16i1.5776 ◽

1970 ◽

Vol 16 (1) ◽

pp. 15-22 ◽

Cited By ~ 5

Author(s):

Abu HenaMohammad Parvez Humayun ◽

AHM Zahurul Huq ◽

SM Tarequddin Ahmed ◽

Md Shah Kamal ◽

Kyaw Khin U ◽

...

Keyword(s):

Histopathological Examination ◽

Malignant Lesion ◽

Malignant Tumour ◽

Neck Surgery ◽

Female Ratio ◽

Medical College ◽

Male To Female ◽

Study Setting ◽

Head Neck Surgery ◽

Head Neck

Objective: To observe the incidence, clinical presentation and to perform comparative studyof different sinonasal masses. Study design: Prospective study. Setting: Department ofotolaryngology and Head-Neck Surgery & ENT OPD of Chittagong Medical College Hospital.Patients & methods: 50 patients are included in this study (39 male & 11 female) between theages of 3 years and 80 years who were treated between August 2006 to January 2007. Studybased on history, clinical, radiological, laboratory and histopathological examination. Results:Mean age for male was 35.12 years and for female was 22.63 years. Male to female ratio was3.5:1. Highest frequency was noted in second decade. Most of patient (78%) were from poorclass. Frequency of inflammatory nasal masses were more in second decade, benign tumourin fourth and fifth decade, malignant tumour in second decade (OAN & NHL) and fifth andsecond decades (others). Rhinosporidiosis were most frequent inflammatory nasal masses.Nasal obstruction was the commonest and orbitus symptoms were less frequent symptoms.But orbital symptoms were more prevalent in malignant lesion. Conclusion: sinonasal massesare found in all age group. Rhinosporidiosis are appearing to be the commonest nasal masses.The prevalence of nasal polyp is also high. Among the malignant sinonasal masses thepercentage of squamous cell carcinoma is high.DOI: 10.3329/bjo.v16i1.5776Bangladesh J Otorhinolaryngol 2010; 16(1): 15-22

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Heat Stroke

Acute Care Casebook ◽

10.1093/med/9780190865412.003.0067 ◽

2018 ◽

pp. 332-335

Author(s):

Alexander Berk

Keyword(s):

Differential Diagnosis ◽

Mental Status ◽

Heat Stroke ◽

Altered Mental Status ◽

Healthy Person ◽

Clinical Suspicion ◽

Metabolic Abnormalities ◽

Airway Protection ◽

Stroke Patients ◽

High Clinical Suspicion

This case illustrates heat stroke presenting as altered mental status in a young healthy person. The differential diagnosis of altered mental status with hyperthermia is broad so a high clinical suspicion is needed to make the diagnosis of heat stroke. Infectious causes should always be ruled out. Once the diagnosis is made, treatment is aimed at actively cooling the patient, lowering temperature to a targeted goal of 102.2°F. Close attention should also be given to airway protection, correction of metabolic abnormalities, evaluation for rhabdomyolysis, and monitoring for cardiac dysrhythmias. All heat stroke patients should be admitted to the hospital for monitoring even after cooling goals are achieved.

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A study of gastrointestinal tumors at kathmandu medical college teaching hospital

Journal of Pathology of Nepal ◽

10.3126/jpn.v8i1.19455 ◽

2018 ◽

Vol 8 (1) ◽

pp. 1285-1288

Author(s):

Sailesh Bahadur Pradhan ◽

Binita Pradhan ◽

Sailuja Maharjan ◽

Prabin Bikram Thapa

Keyword(s):

Gastrointestinal Tract ◽

Teaching Hospital ◽

Histopathological Examination ◽

Benign Lesion ◽

Malignant Lesion ◽

College Teaching ◽

Age Group ◽

Benign Lesions ◽

Cross Sectional ◽

Medical College

Background: Gastrointestinal tract tumour is responsible for more cancers and death than any other cancers. The tumour in GIT include the tumour of the Oral cavity, Esophagus, Stomach, Colon, Rectum, Liver, Gallbladder, Pancreas and Biliary tree.Materials and methods: A cross sectional study was carried out among all the gastrointestinal tract tumours specimens received for histopathological examination in between January 2016 to June 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital. All tumors diagnosed either benign or malignant were included in this study. Ethical clearance was obtained from the Institutional Review Committee in KMCTH.Results: Colorectum was found to be the most commonly involved site for malignant lesion comprising 40.2% among all malignant lesions followed by stomach comprising 28.6%. Malignancy was found to be more prevalent among male with M:F ratio of 1.6:1 in colorectal region and 1.4:1 in stomach cancers. Regarding benign lesions (polyps), rectum was found to be the commonest site (57.5%), followed by colon (20.0%) and stomach, the least common site.Malignant lesions were more common among the age group of 51-60 years (37.66%) with 70.13% above 50 years. Benign lesions were also found to be the most common above 50 years comprising 40.0 percent.Conclusion: Rectum & colon was found to be the most commonly involved site for both malignant and benign lesion. Malignancy is more prevalent among male and common above 50 years of age. However, malignant cases noted in the adult age group are a matter of great concern.

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A comparative study of RIPASA and Alvarado score for the diagnosis of acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20204930 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4006

Author(s):

Praveena Suresh ◽

Rajan Janardhanan ◽

Deepak Paul

Keyword(s):

Acute Appendicitis ◽

Scoring System ◽

Prospective Observational Study ◽

Iliac Fossa ◽

Scoring Systems ◽

Alvarado Score ◽

Medical College ◽

Right Iliac Fossa Pain ◽

Sensitivity Specificity ◽

Ripasa Score

Background: Acute appendicitis is a common problem and can be difficult to diagnose at time. There are many scoring systems to predict the diagnosis of acute appendicitis. The most commonly used scoring system is Alvarado scoring system but, it is far from perfect. In this study we compare Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system to Alvarado scoring system in correctly diagnosing acute appendicitis.Methods: This prospective observational study was conducted in the department of general surgery, Sree Gokulam Medical College and Research Foundation. It comprised of 60 consecutive patients who were admitted with suspicion of appendicitis who had right iliac fossa pain. RIPASA and Alvarado scoring was done and compared to histopathology after surgery. Sensitivity, specificity and accuracy was calculated.Results: Majority of the patients were below 30 years of age majority were males 36 (60%). When Alvarado score predicted appendicitis in 31 (51.77%) and RIPASA in 54 (90%). When the RIPASA score was >7.5 the sensitivity was 100%, specificity 67% and accuracy was 95%.Conclusions: RIPASA scoring system is more accurate to diagnose acute appendicitis especially when RIPASA score is >7.5. literatures.

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COEXISTENCE OF TUBERCULOSIS AND ADENOCARCINOMA OF THE COLON

Journal of Nepal Medical Association ◽

10.31729/jnma.716 ◽

2003 ◽

Vol 42 (145) ◽

pp. 39-41

Author(s):

Yogendra Singh ◽

G Sayami ◽

M Khakurel

Keyword(s):

Histopathological Examination ◽

Psoas Abscess ◽

Iliac Fossa ◽

Right Hemicolectomy ◽

Ascending Colon ◽

Colonic Tuberculosis ◽

Adenocarcinoma Of The Colon ◽

Well Differentiated ◽

The Right

ABSTRACTA 60-years-old, male patient presented with a-tender swelling in the right iliac fossa with right hip flexiondeformity suggesting of psoas abscess. Following emergency drainage of faeculant pus, the general conditionof the patient improved. The barium enema showed leaking ascending colonic ulcer and colonoscopicexamination revealed nonspecific ulcerative lesion in the ascending colon. Repeat investigations were alsonon-conclusive except there was a stricture at the ascending colon on colonoscopy. A second operationshowed that there was a huge mass of terminal ileum, cecum and ascending colon and perforation of ascendingcolonic ulcer most likely carcinoma. Right hemicolectomy was performed with uneventful postoperativeperiod. Histopathological examination revealed well differentiated adenocarcinoma limited to the musclelayer of the ascending colon and features suggestive of colonic tuberculosis at the same site. Antituberculartreatment was completed with regular follow-up and monitoring on CEA level. Patient has been doing well3 years postoperatively. Although rare, the coexistence of colonic tuberculosis with carcinoma may occur. Adefinitive diagnosis can be established only by histological examination.Key Words: Colonic tuberculosis, Adenocarcinoma, Histology.

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Clinical Study of Right Iliac Fossa Mass Pathology At: Central Vidarbha Region

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2466 ◽

2020 ◽

Vol 11 (3) ◽

pp. 3329-3337

Author(s):

Anupam Kakade ◽

Mangesh Padamwar ◽

Ajonish Kamble ◽

Yashwant Lamture ◽

Meenakshi Yeola

Keyword(s):

Differential Diagnosis ◽

Iliac Fossa ◽

Signs And Symptoms ◽

Clinical History ◽

Pathological Process ◽

Clinical Appearance ◽

Medical College ◽

Detailed Clinical History ◽

Interval Appendicectomy ◽

The Right

One of the most common problems experienced in surgical practice, which challenges the surgeon and needs the ability to diagnose through knowing the anatomy and pathological process that can occur inside the abdomen, is a mass in the right iliac fossa. The purpose of this research was to examine clinical appearance, differential diagnosis and treatment methods for patients with the right iliac fossa.Study was carried out in the Dept. of General Surgery at Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi (M), Wardha , Maharashtra , between August 2018 to December 2019. 43 patients with signs and symptoms of right iliac fossa mass were studied by taking detailed clinical history, physical examination, and were subjected to various investigations.In the present study appendicular mass constituted 60.46%, appendicular abscess 09.30% ,ileocaecal tuberculosis 06.97 % , carcinoma caecum 13.95 % , intussusseption02.32%. Patients presented with constitutional symptoms like pain , fever , vomiting , weight loss.Appendicular lump remains the most common entity in right iliac fossa mass patients. Ileocaecal tuberculosis is one of the most common differential diagnosis to be considered for pain abdomen evaluation in rural population. Conservative treatment followed by interval appendicectomy remains the main management modality in appendicular lump. The rare cause of mass in right iliac fossa as intussusception should be kept in mind.

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Intraosseous Hemangioma of Nasal Bone: Unusual Location of a Common Tumor with Literature Review

Sudan Journal of Medical Sciences ◽

10.18502/sjms.v16i3.9702 ◽

2021 ◽

Author(s):

Tagwa Abdullah M. Osman ◽

Sohaila Fatima ◽

Shiza Wajih Siddiqui

Keyword(s):

Differential Diagnosis ◽

Literature Review ◽

Head And Neck ◽

Clinical Examination ◽

Surgical Procedures ◽

Histopathological Examination ◽

Nasal Bone ◽

Clinical Suspicion ◽

Vascular Tumors ◽

Nasal Mass

Hemangiomas are very common benign vascular tumors of head and neck. Intraosseous hemangiomas are rare and very few cases of involvement of nasal bone have been found in literature. A slowly growing hard nasal mass should draw clinical suspicion and should be included in differential diagnosis as it carries with it the risk of uncontrollable hemorrhage during surgical procedures. Clinical examination and radiology are contributory but histopathological examination is confirmatory for diagnosis. Keywords: hemangiomas, intraosseous, nasal bone

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Non infective bullous lesions: a diagnostic challenge in a minimally equipped centre- based solely on microscopic findings

African Health Sciences ◽

10.4314/ahs.v20i2.42 ◽

2020 ◽

Vol 20 (2) ◽

pp. 885-890

Author(s):

Rashi Garg ◽

Kaushal Bhojani

Keyword(s):

Skin Biopsy ◽

Microscopic Examination ◽

Histopathological Examination ◽

Clinical Suspicion ◽

Clinical Correlation ◽

Diagnostic Challenge ◽

Drug Induced ◽

Histopathological Features ◽

Medical College ◽

Microscopic Findings

Vesicobullous lesions of skin may occur in different forms of dermatosis, which include various inflammatory, infective, autoimmune, drug induced as well as genetic conditions. Autoimmune bullous lesions, may be fatal if not treated with ap- propriate agents. Bearing in mind, the morbidity of these diseases, it is important to establish a firm diagnosis. A diagnostic skin biopsy with immunofluorescence is frequently used to confirm a clinical diagnosis, especially where it is not apparent clinically. There are many centres in India where immunofluorescence is not available and the diagnosis in these lesions is based on clinical and histopathological features only. Here in this study, we studied 53 skin punch biopsies with clinical suspicion of vesicobullous lesions followed by histopathological examination was carried out over a period of 2 years in a Medical College in Gujarat. Lesions were categorised based on the location of the blister. 1) Suprabasal 2) subcorneal 3) and subepidermal. Further subtyping was done based on additional histopathological features and clinical correlation. All the patients responded appropriately to the treatment and the results correlated well with the immunofluorescence done in a few cases. This study lays emphasis upon the histopathology and clinical features keeping in consideration of the lack of ancillary techniques in many centres especially in the developing world. Keywords: Non infective bullous lesions; microscopic examination.

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Histopathological Examination in the Categorization of fungal Rhinosinusitis - a Retrospective Study

Nepalese Medical Journal ◽

10.3126/nmj.v4i2.41377 ◽

2021 ◽

Vol 4 (2) ◽

pp. 478-481

Author(s):

Sangeetha Kandasamy ◽

Megala Chandrasekar ◽

Thamilselvi Ramachadran

Keyword(s):

Clinical Diagnosis ◽

Gold Standard ◽

Nasal Polyps ◽

Histopathological Examination ◽

Clinical Suspicion ◽

Fungal Sinusitis ◽

Medical College ◽

Fungal Rhinosinusitis ◽

Hematoxylin And Eosin ◽

Made In

Introduction: Fungal Rhinosinusitis is broadly defined as any sinonasal pathology related to the presence of fungi and is increasingly recognized worldwide. This study aimed to assess and ascertain the need for histopathological examination in the management of fungal Rhinosinusitis. Materials and Methods: This study was performed over two years, from April 2019 to April 2021, in the Department of Pathology, Vinayaka Missions KirupanandaVariyar Medical College and Hospital, Salem. A total of 383 cases of rhinosinusitis/nasal polyps were studied. Histopathological examination and categorization were done and compared with clinical diagnosis. Results: Only 4/18 cases of acute fungal Rhinosinusitis were correctly diagnosed(22.22%). Nineteen cases of the fungal ball were diagnosed, but none was correctly categorized. Clinical suspicion of fungal sinusitis was present in 10 cases of Rhinosinusitis, which turned out to be chronic Rhinosinusitis in histopathology. In AFRS, fungal elements were overlooked in Hematoxylin and Eosin stained slides and identified only by Grocottmethenamine silver in one-fourth of the cases. Conclusions: Though clinical diagnosis was made in 86% of fungal rhinosinusitis cases, correct categorization was done only in one-third of cases. CT scan could diagnose 60% of cases, but none was categorized. As treatment depends on the type of fungal Rhinosinusitis, histopathological examination is the gold standard for diagnosing and treating fungal Rhinosinusitis.

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Reconsidering NMIHBA Core Features: Macrocephaly Is Not a So Unusual Sign in PRUNE1-Related Encephalopathy

Journal of Pediatric Neurology ◽

10.1055/s-0040-1715526 ◽

2020 ◽

Author(s):

Roberta Battini ◽

Enrico Bertini ◽

Roberta Milone ◽

Chiara Aiello ◽

Rosa Pasquariello ◽

...

Keyword(s):

Nervous System ◽

Differential Diagnosis ◽

Clinical Features ◽

Neurodevelopmental Disorder ◽

Recurrent Mutation ◽

Clinical Suspicion ◽

Alexander Disease ◽

Brain Anomalies ◽

Progressive Encephalopathy ◽

Core Features

Abstract PRUNE1-related disorders manifest as severe neurodevelopmental conditions associated with neurodegeneration, implying a differential diagnosis at birth with static encephalopathies, and later with those manifesting progressive brain damage with the involvement of both the central and the peripheral nervous system.Here we report on another patient with PRUNE1 (p.Asp106Asn) recurrent mutation, whose leukodystrophy, inferior olives hyperintensity, and macrocephaly led to the misleading clinical suspicion of Alexander disease. Clinical features, together with other recent descriptions, suggest avoiding the term “microcephaly” in defining this disorder that could be renamed “neurodevelopmental disorder with progressive encephalopathy, hypotonia, and variable brain anomalies” (NPEHBA).

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