MANAGEMENT OF CLINICALLY INDEFINITE RIGHT ILIAC FOSSA LESIONS

Abstract

Many diseases can cause lesions in right iliac fossa with indefinite clinical presentations. Improper diagnosis, missed lesions and unexpected morbidity may follow variable clinical puzzles. Objective: The aim of this study was to assess the clinically indefinite right iliac fossa lesions and to evaluate the role of multislice CT to improve their diagnostic accuracy and surgical management. Methods: Fifty two patients with indefinite clinical presentations related to right iliac fossa lesions were assessed before and after multiplanner reformatted images of multislice CT. The impact on diagnostic accuracy and surgical management was evaluated. Results: Variable lesions were detected in these patients. CT showed different radiological diagnostic signs. The diagnosis of clinically indefinite lesions was improved by MDCT with sensitivity 95.8%, specificity 83.3% and accuracy 94.4%. Conclusions: This study showed the great variability of lesions in the right iliac fossa and of therapeutic surgical procedures. Not every pain is due to appendicitis; and hasty diagnosis must be avoided. Multislice CT and multiplanner reformatted images were markedly valuable in providing diagnostic signs, guiding to select further valuable investigations, staging of tumors, assessment of operability, planning the proper surgical management and avoiding unnecessary surgical intervention for lesions that can be treated by non-surgical measures.

Key words: Right iliac fossa lesions – multislice CT – diagnostic accuracy- radiological signs.