Fever and pain in the right iliac fossa : What the radiologist needs to know

Congress:

ECR 2020

Poster Number:

C-15098

Type:

Educational Exhibit

Keywords:

Observational, Not applicable, Inflammation, Infection, Acute, Computer Applications-Detection, diagnosis, Ultrasound, CT, Emergency, Abdomen, Abdominal Viscera, Performed at one institution

Authors:

W. Ben Mansoura, S. boukriba, H. Mizouni; Tunis/TN

DOI:

10.26044/ecr2020/C-15098

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-15098

Fig. 2: CT appearance of acute appendicitis shows a dilated appendix (> 6 mm diameter)...

Fig. 1: According to etiology, the main causes of septic syndrome of the right iliac...

Fig. 4: Contrast-enhanced CT scan of lower abdominal cavity (axial with reconstruction...

Learning objectives

To describe the mostcommon pathologies presenting with septic syndrom of the right iliac fossa. To illustrate through a rich iconography of our institution the main radiological aspects of the pathologies most frequently encountered.

Background

In the adult, fever and pain in the right iliac fossa are a frequent reason for emergency consultation. The clinical examination is often nonspecific and the differential diagnosis spectrum is wide,usually dominated by acute appendicitis. However, there are many other diseases that may appear with similar symptoms and that should be known to the radiologist in order to provide the appropriate diagnosis. Accurate diagnosis is imperative at all times, it can change the patient’s management from surgical to non surgical and avoid anunneeded operation. In...

Findings and procedure details

Right iliac fossa pain should not be related only to digestive diseases, but also to urinaryand gynecologicaldisorders.Fig. 1 Imaging techniques that are suggested are ultrasound and CT scan. Ultrasound should be preferred in children, pregnant women and throught young patients. CT scans are more often used in first line when there are signs of seriousness from the start, in elderly subjects or in second line if the ultrasound is non contributive. Multislice CTscanhold a key roleasan effective and rapid diagnostic technique to be done in...

Conclusion

Radiologists should be aware of the multiple causes ofseptic syndrome of the right iliac fossa in order to provide an accurate diagnosis and avoid misdiagnosis.

Personal information and conflict of interest

W. Ben Mansoura; Tunis/TN - nothing to disclose S. Boukriba; Tunis/TN - nothing to disclose H. Mizouni; Tunis/TN - nothing to disclose

References

1. Infection of the right iliac fossa - EM|consulte [Internet]. [cité 20 janv 2020]. Disponible sur: https://www.em-consulte.com/en/article/731121 2. Wang H, Chen Y-Q, Wei R, Wang Q-B, Song B, Wang C-Y, et al. Appendiceal mucocele: A diagnostic dilemma in differentiating malignant from benign lesions with CT. AJR Am J Roentgenol. oct 2013;201(4):W590-595. 3. Lee IK. Right Colonic Diverticulitis. J Korean Soc Coloproctology. août 2010;26(4):241‑5. 4. Boortz HE, Margolis DJA, Ragavendra N, Patel MK, Kadell BM. Migration of Intrauterine Devices: Radiologic Findings and Implications for Patient Care....