Differential Diagnosis for Appendicular Lump
- Single most likely diagnosis
- Appendicular mass (phlegmon or abscess): This is the most likely diagnosis due to the location and presentation of the lump. An appendicular mass forms as a result of the body's attempt to localize and contain an appendiceal infection, leading to a palpable mass in the right lower quadrant.
- Other Likely diagnoses
- Intussusception: Although more common in children, intussusception can occur in adults and may present as a palpable mass if it involves the terminal ileum and appendix.
- Meckel's diverticulum: If a Meckel's diverticulum becomes inflamed or obstructed, it can present as a lump in the right lower quadrant, mimicking an appendicular mass.
- Ileocecal tuberculosis: This condition can cause a mass in the right lower quadrant due to inflammation and scarring of the ileocecal region.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Carcinoid tumor: Although rare, a carcinoid tumor of the appendix can present as a lump and has significant implications for treatment and prognosis.
- Appendiceal carcinoma: Primary carcinoma of the appendix is rare but can present as a mass and requires prompt diagnosis and treatment.
- Ovarian torsion (in females): While not directly related to the appendix, ovarian torsion can present with acute abdominal pain and a palpable mass, making it a critical diagnosis not to miss.
- Rare diagnoses
- Gastrointestinal stromal tumor (GIST) of the small intestine: A GIST can rarely present as a lump in the right lower quadrant if it involves the terminal ileum.
- Lymphoma involving the appendix or ileocecal region: Lymphoma can cause a mass in this region, although it is a rare occurrence.
- Metastatic disease to the appendix: Rarely, metastatic cancer can involve the appendix and present as a lump.