A prospective study of relevance of interval appendicectomy in treatment of appendicular lump

Abstract

Appendicitis is one of the most common diseases that a surgeon faces in practice. Sometimes patients may present a few days after the onset of acute appendicitis with a palpable mass a phlegmon is a type of inflammatory tumour that consists of an inflamed appendix, as well as the larger omentum and associated viscera.To evaluate the need for interval appendicectomy in patients with appendicular lump. The study included all patients with an appendicular mass and was put on conservative management. . Failures of resolution of mass with conservative management were taken up for appendicectomy. The patients were discharged on successful conservative management and followed up at regular intervals for 12 months. Any patient with features suggesting recurrence of acute appendicitis on follow up was admitted and taken up for appendicectomy.  All of the above information was gathered and statistically evaluated.Out of 58 cases of appendicular mass, 3 (5.17%) were operated due to failure of resolution of mass. The remaining 55 (94.83%) cases were successfully treated conservatively and followed up regularly for 12 months. 4 (7.27%) patients were lost to follow up. 1 (1.81%) patient revealed carcinoma of caecum and underwent right hemicolectomy. The remaining 50 (86.2%) cases, from which 42 (84%) patients remained recurrence free. 8 patients (16%) had recurrent appendicitis, out of which 7 (14%) patients underwent emergency appendicectomy, 1(2%) patient developed appendicular lump and was treated non operatively. In our study recurrence rate of acute appendicitis following resolution of appendicular mass is low (16%). So interval appendicectomy have to no longer be the rule in all patients after resolution of mass and should be reserved for patients with recurrences or with increased risk factors for recurrence.