Mass in Right lower quadrant

Q) A 55 year old lady presents with vague pain in right lower abdomen. Physical examination reveals a well defined mass there which is non tender and freely mobile. It is non pulsatile as well. What is the most likely possibility?

a) Appendicular mass

b) Mesenteric cyst

c) Perforated tubo ovarian mass

d) Meckel's diverticulum



Mesenteric cysts are uncommon lesions found in this age group. It typically presents as a freely mobile mass  which moves perpendicular to small blwel axis. It is painless as well.

Appendicular mass will have a preceding history of pain abdomen

Similarly perforated  tubo ovarian mass will also have a history of pain 

Meckel's diverticulum does not present as this kind of mass


Gall Bladder Cancer in setting of APBDJ

Q) Gall bladder cancer arising in the setting of  Abnormal Pancreatico Biliary duct Junction (APBDJ) , all are true except

a) It occurs in younger age

b) Prevalent in Asian countries

c) More common in males

d) Less often associated with Gall stones

c)  It is more common in females

In APBDJ, pancreatic and biliary duct meet more than 15 mm away from the duodenal wall. APBDJ is seen more in asian countries and is associated as a cause of gall bladder cancer.

It is seen in younger age group

Most of the patients are females

Ref article-

EUS criteria of malignant lymph node

Q) One of the following is not a criteria of malignancy in lymph node on EUS

a) Size more than 1 cm

b) Prominent intranodal vasculature

c) Sharp well defined  borders

d) Hypoechoic