Role of Multidetector Computed Tomography in Evaluating Acute Right Iliac fossa Pain
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Abstract
Acute right iliac fossa (RIF) pain is a common clinical presentation with diverse underlying causes, often posing a diagnostic challenge. Multidetector computed tomography (MDCT) has emerged as a critical imaging modality in the evaluation of such cases, offering high sensitivity and specificity in identifying the underlying pathology. This study explores the utility of MDCT in diagnosing acute RIF pain, focusing on its diagnostic accuracy, role in differential diagnosis, and impact on clinical management. A total of 51 patients presenting with acute RIF pain underwent MDCT, with findings correlated to clinical and surgical outcomes. MDCT demonstrated excellent diagnostic accuracy in detecting appendicitis, the most common cause of acute RIF pain, by visualizing features such as appendiceal diameter, wall thickening, and periappendiceal inflammation. It also accurately identified alternative diagnoses, including ovarian pathologies, mesenteric lymphadenitis, ileitis, and diverticulitis, which accounted for a significant portion of non-appendiceal cases. The study highlights the ability of MDCT to differentiate between surgical and non-surgical conditions, reducing unnecessary interventions. In cases requiring surgical management, MDCT findings contributed to timely and precise decision-making. The modality's ability to evaluate adjacent structures, such as the bowel, urinary tract, and reproductive organs, further enhanced its diagnostic value, particularly in atypical presentations. Limitations included radiation exposure and cost considerations, although these were outweighed by the benefits of improved diagnostic confidence and patient outcomes. The findings underscore the importance of MDCT as a frontline diagnostic tool in acute RIF pain, emphasizing its role in early and accurate diagnosis, guiding appropriate treatment, and minimizing diagnostic delays. Future research should focus on optimizing MDCT protocols and integrating it with clinical scoring systems to further enhance its utility in resource-limited settings.