DR.

SUSHIL KARIA
MS, FRCS (ENGLAND),
FRCS (EDINBURGH),
FRCS (GLASGOW)
COUNSULTANT UROLOGICAL SURGEON
ANISH INSTITUTE OF KIDNEY DISEASES
B.T.SAVANI KIDNEY HOSPITAL
H.J.DOSHI HOSPITAL & RESEARCH CENTRE
RAJKOT

SPECIAL INTEREST :
URO-ONCOLOGY & RENAL TRANSPLANT SURGERY
ASSOCIATE PROF. UROLOGY AND SURGERY, CUSMC
 Acute
Lump in RIF
Chronic
 Conditions
• Lump from Abdominal wall

• Lump from inside Abdominal cavity

• Congenital
• Traumatic
• Inflammatory
• Neoplastic
• Miscellaneous
 Arising from
Abdomial Cavity
(A) Acute Lump – Painful

(B) Chronic Lumps – Painless

 Inflammatory
(1) Appendicular Mass
(2) Appendicular Abscess
(3) Para Colic abscess
(4) Amoebic Typhlitis with Granuloma
(5) Regional ileitis – Chrohn’s Disease
Granulomatous Mass
Familial or ideopathic
(6) Mesentric lymphadenitis -
Acute
Chronic Non Specific
Young Children
(7) Tuberculous Mesentric L.N.
- Mycobacterium T.B.
- M. Bovis
(8) T.B. caecum Or
ileo – caecal junction
hyper plastic tuberculosis
(9) Ovarian Mass (Tubo – Ovarian)
(10) T.B. Pyo – Salpinx
(11) Actinomycotic granuloma of
Caecum
Actinomyeces Israeli
(12) Psoas Abscess – T.B. Spine
 Neoplastic
(A) Benign

(B) Malignant
 Benign
Neoplastic
Malignant

(1) Carcinoma Caecum. May be with

intussusception.

(2) Carcinoid Tumuor of ileum

(3) Mesentric Cysts:-
Chylolymphatic
Enterogenous
Urogenital remnant
Dermood (Teratomtous) Cyst
Presented as Painles abdominal
Swelling in central abd
or
Rt side abdomen
(4) Carcinoid of Caecum

(5) Neoplasms of Mesentry:-

Benign – Lipoma, Fibroma,
Fribromyoma
Malignant:- Primary lymphosarcoma
Carcinoma
Secondary
Raticuloma
 Neoplastic
(6) Retroperitoneal Cyst
D/D – Large Hydro–Nephrosis

(7) Primary Retroperitoneal Neoplasms

- Retroperitoneal Lipoma
- Retroperitoneal Sarcoma
(8) Secondaries Near iliac Vessels
From –
- Peritoneal Tumours
- Leg
- Penis
- Bladder, Pelvic Organs
(9) Tumour in Rt undescended Testis
(10) Carcinoid Tumour Appendix 65 %
ileum – 25 %
(11) Primary Adeno – Carcinoma of
Appendix
 Others - Rare
(1) Intussuseception in young children
(2) Adolescent – By inverted
Mackel’s diverticulm causing
intessuseception
(3) Aneurysm of External or
Common iliac artery
(4) Rt. Ovarian cyst or Mass or Twisted
ovarian cyst
(5) Mucocoel of Appendix
 Congenital
Un ascended Kidney
 Traumatic
• Haemetoma due to injury

• Ruptured abdominal musculature

 Arising from
Abdominal wall
(1) Skin lesions
(2) Lipoma, Sebaceous Cyst,
(3) Sarcoma
(4) Secondary invasion of abdominal
wall from other Tumours
(5) Inter Muscular or
Spigelian Hernia