Make a image of algorithm of how to approach right iliac fossa mass by

Make a image of algorithm of how to approach right iliac fossa mass by differentiating it into abdominal swelling intraperitoneal and retroperitoneal on the basis of inspection palpation percussion points add ballotment, movements on palpation

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Algorithm: Approach to Right Iliac Fossa Mass

Here is the complete algorithm for approaching a Right Iliac Fossa (RIF) mass. It covers:

Three examination pillars:

Inspection — respiratory movement, skin changes, pulsations, peristalsis
Palpation — surface, consistency, margins, mobility, ballotment (positive = retroperitoneal), and movement on palpation (moves with hand vs slips away)
Percussion — key differentiator: a resonant band of colon above the mass signals retroperitoneal origin (bowel is displaced anteriorly)

Key differentiating points at a glance:

Feature	Intraperitoneal	Retroperitoneal
Moves with respiration	✔ Yes	✘ No/Restricted
Bimanual ballotment	Negative	Positive
Resonant band above	Absent	Present
Palpable margins	All sides	Anterior only
Mobility	Often mobile	Fixed
Movement on palpation	Moves with hand	Slips/independent

Common RIF causes — intraperitoneal (appendicular mass, caecal Ca, Crohn's, ovarian cyst) vs retroperitoneal (psoas abscess, lymphadenopathy, iliac aneurysm, lower pole renal mass).

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