5. Differential diagnosis investigation and management of patients presenting with a left iliac fossa mass.

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Across
  1. 5. May present like IBS initially. Should perform a pelvic examination and pelvic ultrasound with associated blood marker tests
  2. 7. Enlarged lymph nodes in this region can be due to infection or malignancy (pelvic infections, abdominal infections, cellulitis, cancer metastases, leukaemia, lymphoma)
  3. 8. This can occur following previous surgery on the abdominal wall, is rarely symptomatic, but there is risk of strangulation
Down
  1. 1. Commonly adenocarcinoma, causing abdo pain, changes in bowel habits, rectal bleeding and anaemia
  2. 2. herniation of the bowel layers through the muscle layer, is usually asymptomatic but can cause IBS like symptoms or rectal bleeding, if severe
  3. 3. Collection of pus within the muscle, causing fever and pain radiating to the back, buttock, groin or hip. Treatment involves antibiotics and CT guided or surgical drainage
  4. 4. Common birth defects in males, where testicles fail to descend. Treatment is surgical
  5. 6. Twisting of the colon. At risk of obstruction and ischaemia. X-ray shows a coffee bean sign. Treatment involves decompression using a sigmoidoscope.