Differential Diagnosis for Right Iliac Fossa Mass
Single Most Likely Diagnosis
- Appendicitis: This is often the first consideration for a right iliac fossa mass due to its common presentation with pain, tenderness, and sometimes a palpable mass in the right lower quadrant of the abdomen. The mass could be an inflamed appendix or an appendicular mass.
Other Likely Diagnoses
- Cecal Diverticulitis: Similar to appendicitis, cecal diverticulitis can present with right lower quadrant pain and a mass if an abscess or significant inflammation is present.
- Intestinal Obstruction: Although not always a direct cause of a mass, an obstruction can lead to significant bowel dilation, which might be palpable, especially if it involves the cecum or the terminal ileum.
- Mesenteric Lymphadenitis: This condition, often seen in children and young adults, can mimic appendicitis and sometimes presents with a palpable mass in the right iliac fossa due to enlarged lymph nodes.
- Right Ovarian Cyst or Torsion: In females, a large ovarian cyst or torsion can present as a mass in the right iliac fossa, accompanied by acute pain.
Do Not Miss Diagnoses
- Ectopic Pregnancy: Although less common, an ectopic pregnancy can present with abdominal pain and a mass, and missing this diagnosis can be catastrophic.
- Intussusception: More common in children but can occur in adults, intussusception is a condition where a part of the intestine telescopes into another, which can cause bowel obstruction and potentially a palpable mass.
- Cancer (e.g., Carcinoid Tumor, Lymphoma): Various types of cancer can present with a mass in the right iliac fossa. While less common, these diagnoses are critical not to miss due to their significant implications for treatment and prognosis.
Rare Diagnoses
- Right Iliac Fossa Hematoma: A collection of blood in the right iliac fossa, which could be due to trauma, anticoagulation, or other bleeding disorders.
- Actinomycosis: A rare bacterial infection that can cause chronic inflammation and abscess formation, potentially presenting as a mass.
- Hydatid Cyst: In endemic areas, a hydatid cyst of the liver or other abdominal organs can rupture and present as a mass in the right iliac fossa.
- Retroperitoneal Fibrosis: A rare condition characterized by the proliferation of fibrous tissue in the retroperitoneum, which can encase and obstruct structures, potentially presenting with a palpable mass.