Vol. 1, Issue 1 (2015)
A study of causes of right Iliac fossa pain with comparison of operative vs conservative management
Author(s): Jatinkumar Bipinchandra Modi
Abstract: Background and Objectives: Patient with pain in the right iliac fossa (RIF) may confront the surgeon, Paediatrician, obstetrician and gynaecologist. Thorough understandings of the anatomy and pathological processes that may occur within the abdomen are essential for an accurate diagnosis and plan of treatment. Some patients will require immediate surgical intervention, whereas others will improve with conservative treatment. The purpose of the present study is to recognise certain well defined clinic-pathological entities, differential diagnosis of pain in the right iliac fossa and the relative incidence of various aetiologies. Methods: A prospective randomized study was conducted on 50 patients in Smt. NHL Municipal Medical College-Smt SCL Hospital. All were indoor patients with a history of pain in right iliac fossa were included in the present study. A thorough clinical examination was undertaken in each patient, including rectal examination in all cases and vaginal examination in those women where indicated. Results: Out of the 50 patients, 20 were males and 30 were females, with a male: female ratio of 1:1.5 with all ranged patients. Acute appendicitis (36%), no doubt, is the commonest diagnosis of the patients, presenting with acute R.I.F pain followed by Non specific mesenteric lymphadenitis(16%) and right ureteric calculi (16%). 40 percent were successfully treated conservatively, whereas 60 percent failed conservative treatment and underwent surgery. The major complication seen after the operation was wound infection which occurred in 3 operative cases. Mean hospital stay duration was 2.83 days in conservative management and 4.5 days in operative cases. Conclusion: A number of gastrointestinal, urological, gynecological conditions can present as acute pain in the right iliac fossa. So, a sound knowledge regarding history taking, clinical examination, especially pelvic examination, relevant investigations and the principles of management of these conditions is mandatory before proceeding for any type of surgery for acute pain R.I.F especially for junior residents.