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Query: UMLS:C0423647 (iliac fossa pain)
 157 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective study 152 consecutive patients presenting with acute abdominal pain were assessed clinically and an ultrasonographic examination was performed immediately. Of these, 16 (11 per cent) patients would normally have had an immediate ultrasonographic scan requested; routine (within 24 h of admission) ultrasonographic examination would have been requested in a further 66 (43 per cent) patients. In 70 (46 per cent) patients an ultrasonographic examination would not have been requested. Ultrasonography altered the diagnosis in one patient from probable appendicitis to cholecystitis. Ultrasonography missed one abdominal aortic aneurysm and one empyema of the gallbladder. Ultrasonography had a sensitivity of 96 per cent, a specificity of 94 per cent, a positive predictive value of 96 per cent, a negative predictive value of 94 per cent and an accuracy of 95 per cent in diagnosing appendicitis. Exactly the same values were found for the clinical diagnosis of appendicitis. The study shows that routine immediate ultrasonographic examination of the acute abdomen is rarely helpful, with the possible exception of appendicitis. Where an urgent ultrasonographic scan is necessary on clinical grounds the expertise of a radiologist is probably required, whereas in specific areas, for example in the diagnosis of right iliac fossa pain, there may be a place for training the surgical trainee.
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PMID:Ultrasonography in the acute abdomen. 195 78

A 38-year-old man presented with acute onset of left iliac fossa pain. He had never noticed a left testis. An ultrasound scan showed a solid pelvic mass. Alfafoetoprotein and HCG were normal. Laparotomy for an acute abdomen was performed and revealed torsion of the left intra-abdominal testis. A left orchiectomy was performed. The patient made an uneventful recovery. Histology showed seminoma and carcinoma in situ. A testicular biopsy from the right testis showed no malignancy. A detailed examination of the genitalia should be part of the usual abdominal examination.
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PMID:[Intra-abdominal torsion of the testis with seminoma]. 922 89

This retrospective study of 645 black patients, carried out over a five year period, showed that appendicitis is twice as common in males as in females and that it occurs predominantly in young people (median age 20 years). The classical presentation of periumbilical pain (16%) was outnumbered by right iliac fossa pain (36%) and non-specific pain (27%). The majority perforated (43%) and appendiceal inflammation was second commonest (37%). The negative appendicectomy rate was 8.8% and there was a diagnostic error of 14%. Mortality was two per cent mainly from patients complicated by peritonitis. Hospital stay was 7 +/- 7 days, with the longest stay following peritonitis. A diagnosis of appendicitis should always be entertained in an African patient presenting with an acute abdomen and, where the diagnosis is in doubt, a laparotomy should be performed.
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PMID:Appendicitis among African patients at King Edward VIII Hospital, Durban, South Africa: a review. 964 Aug 28

Post-partum ovarian vein thrombosis (POVT) is uncommon, but the true incidence is not known. Ninety per cent of cases present as right iliac fossa pain within 10 days of delivery. Anti-coagulation and intravenous antibiotics are the mainstay of treatment. We report three cases that were referred to our unit. These cases illustrate the difficulty in the clinical diagnosis of POVT and highlight the importance of its inclusion in the differential diagnoses of an acute abdomen in post-partum patients. POVT can be accurately diagnosed by appropriate noninvasive investigations and a laparotomy avoided.
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PMID:Post-partum ovarian vein thrombosis. 1152 21

Solitary caecal diverticulum is an uncommon entity and therefore difficult to diagnose except at surgery. Caecal diverticulitis is an infrequent cause of acute abdomen and usually presents in a manner similar to acute appendicitis. It is extremely difficult to differentiate it preoperative from acute appendicitis and such distinction is usually made in the operating room. The optimal management of this clinical condition is still controversial, ranging from conservative treatment with antibiotics to aggressive surgical resections.We report a case of a 61 year old Caucasian who presented with acute onset right iliac fossa pain indistinguishable from acute appendicitis. The true diagnosis of a perforated acute caecal diverticulitis with an abscess mass was only made at operation in the presence of a macroscopically normal appendix. We reviewed the literature to highlight the difficulty of a preoperative diagnosis and the need for a high index of suspicion especially in the older age group presenting in manner similar to acute appendicitis.
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PMID:Caecal diverticulitis presenting as acute appendicitis: a case report. 1964 52

We present a case of a 72 year old male patient, who presented to the emergency department with a 2 day history of right iliac fossa pain. On examination he was apyrexial and haemodynamically stable, yet displayed signs of right iliac fossa peritonism. Inflammatory markers were mildly raised. Computed tomography and diagnostic laparoscopy both demonstrated typical features of epiploic appendagitis. Epiploic appendagitis is an uncommon cause of the acute abdomen, yet is probably underdiagnosed. The term was first used by Lynn et al. in the mid 1950s. With the increase in CT scanning and diagnostic laparoscopy, we feel that both surgeons and radiologists need to be increasingly aware of the clinical and radiological appearances of epiploic appendagitis.
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PMID:Epiploic appendagitis: a case report highlighting correlation between clinical features, computed tomography images and laparoscopic findings. 2045 85

Post-partum ovarian vein thrombosis is an uncommon clinical presentation. 90% of cases present as right loin and right iliac fossa pain, within 10 days of the puerperal period. Two such cases that were referred to the Imaging department as suspected appendicitis/ureteric colic are reported. The findings seen on imaging illustrate the difficulty in the clinical and radiological diagnosis of post-partum ovarian vein thrombosis and highlight the need to include it as a differential diagnosis in cases of post partum acute abdomen. Post-partum ovarian vein thrombosis can be accurately diagnosed by appropriate non-invasive investigations to enable early therapy with anti-coagulants and intravenous antibiotics which are the mainstay of treatment. Surgery can be avoided if diagnosis is made early.
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PMID:Puerperal ovarian vein thrombosis presenting as rt loin pain and hydronephrosis: report of 2 cases. 2204 62

Omental infarction is an uncommon cause of acute abdomen in the pediatric population. We report a case of a 4-year-old male child with right iliac fossa pain. The final diagnosis was made on ultrasound and computed tomography findings. This entity needs to be differentiated from acute conditions like appendicitis, avoiding surgery.
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PMID:Omental infarction: An unusual cause of right iliac fossa pain in children. 2686 93

The susceptibility of the undescended testis to malignant transformation is well documented. The most common location of the undescended testis is within the inguinal canal, with only a minority located within the abdominal cavity. When a testicular mass develops, the risk of torsion increases. We describe a large intra-abdominal testicular seminoma that had undergone torsion, rupture and haemorrhage, presenting as an acute abdomen. A 30 year old man presented to the emergency department with right iliac fossa pain. Computed tomography in the emergency department showed haemoperitoneum and a torted large left testicular mass, likely malignant. The patient underwent laparotomy and excision of the mass. Histologic examination revealed a grossly enlarged seminomatous testis which had torted and ruptured. While pre-operative imaging diagnosis of an intra-abdominal testicular seminoma has been published, reports are few. To the best of the author's knowledge pre-operative imaging diagnosis of a malignant testicular mass with torsion and intra-abdominal haemorrhage presenting as an acute abdomen has not been described before.
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PMID:A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen. 2720 Jan 73

Abdominal pain with dengue fever can be a diagnostic challenge. Typically, pain is localised to the epigastric region or associated with hepatomegaly. Patients can also present with acute abdomen. We report a case of a girl with dengue fever and right iliac fossa pain. The diagnosis of acute appendicitis was made only after four days of admission. An appendicular mass and a perforated appendix was noted during appendectomy. The patient recovered subsequently. Features suggestive of acute appendicitis are persistent right iliac fossa pain, localised peritonism, persistent fever and leucocytosis. Repeated clinical assessment is important to avoid missing a concurrent diagnosis like acute appendicitis.
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PMID:Appendicular mass complicating acute appendicitis in a patient with dengue fever. 2732 51


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