10.03.2017

1. RIGHT ILLIAC FOSSA LUMP
Sandipan Bhattacharya
10.03.2017
Malda Medical College

3. RIGHT ILLIAC FOSSA(STRUCTURES)
• APPENDIX WITH MESOAPPENDIX
• CAECUM
• TERMINAL ILEUM
• RETROPERITONEAL TISSUE
• ILIAC NODES
• ILIAC ARTERIES

4. RIGHT ILIAC FOSSA MASS
ABDOMINAL WALL INTRAPERITONEAL RETROPERITONEAL MISCELLANEOUS
Haematoma Appendicular abscess Iliopsoas abscess Loose bodies
Abscess Carcinoma of colon Undescended testis Ovarian mass/ tubo-
ovarian mass
Incisional Hernia (post
appendectomy)
Appendicular mass Retroperitoneal lymph
nodes
Uterine mass
Tumours
a. benign (lipoma,
fibroma, neurofibroma,
fibromatosis)
b. malignant (desmoids
tumour, soft tissue
sarcoma)
Ileocecal tuberculosis Aneurysm
Ameboma
Psoas abscess
Diverticulitis
Crohn’s disease

6. MASS CHARACTERISTICS
APPENDICULAR MASS ILEO -CAECAL TB CARCINOMA CAECUM
TENDER
SOFT TO FIRM
ILL DEFINED BORDERS
IRREGULAR AND FIXED
NON TENDER
FIRM TO HARD
HIGHLY PLACED
DOUGHY ABDOMEN
NON TENDER
HARD
FIXED
ASCITIS
HEPATOMEGALY

7. COLON CARCINOMA
• INCIDENCE
-Most common malignancy of GI tract
-Third most common cancer in the world
-95% colorectal carcinomas are
adenocarcinoma

8. COLON CARCINOMA
• RISK FACTORS
1.AGEING- incidence increases after 50
years
2. HEREDITARY- 80% sporadic, 20% with
known family history.
3.DIETARY FACTORS AND ENVIRONMENTAL
FACTORS: -
i)Diet rich in animal fat- directly toxic to
colonic mucosa inducing early malignant
changes.
ii) low dietary fibres
iii)alcohol
iv)obesity and sedentary lifestyle

9. COLON CARCINOMA
4. INFLAMMATORY BOWEL DISEASE-
Chronic inflammation leading to
malignant changes.
5. OTHERS: -
i) Cigarette smoking - >35 years age
ii) Ureterosigmoidostomy
iii) Pelvic irradiation

10. PATHOGENESIS:-

12. MUTATION IN MICROSATELITE SEQUENCE IN
CODING AND PROMOTOR REGIONS OF
GENES REGULATING CELL GROWTH
BAX TGF-B
INHIBITS COLONIC
EPITHELIAL CELL
PROLIFERATION
SURVIVAL OF
GENETICALLY
ABNORMAL CLONES