A comparative study of appendicular lump management

Patel, Bhumika Jayantilal; Patel, Kalpesh

doi:10.5455/2349-2902.isj20150521

Cited by 12 publications

(16 citation statements)

References 7 publications

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“…In this study, I found that the incidence of the appendicular lump was 10.18% and this is comparable with other author's study varying from 2-6%. 3,4 The treatment of appendicular mass is taking a turn from the traditional approach of initial conservative treatment followed by interval appendectomy to immediate appendectomy. However, this change is not widely accepted and a large number of surgeons continue to adopt the same traditional conservative approach.…”

Section: Discussionmentioning

confidence: 99%

“…Many authors have stayed that early appendicectomy is more beneficial than traditional conservative management. 1,3,18,19 It reduces the convalescence period, short hospital stays and outcomes were favorable. This correlates with this study.…”

Section: Discussionmentioning

confidence: 99%

“…This usually follows a late presentation or a failure of diagnosis at presentation. 3 Traditionally acute appendicitis was principally diagnosed on repeated physical examination after active observation without much reliance on laboratory investigations. 4 Greater reliance on putatively objective tools for the diagnosis can delay the diagnosis and has changed the outlook for some patients.…”

Section: Introductionmentioning

confidence: 99%

“…1,2,7 Lump develops when appendicitis is caused by obstruction of the lumen of the appendix and there is a danger of perforation of the appendix following ischemic necrosis and gangrene of the appendicular wall. 3,8 As a natural protective mechanism, the omentum, and small bowel wrap up the inflamed appendix in an attempt to prevent infection from spreading by isolating the inflamed organ from the rest of the abdominal cavity. 9 There may have been an evolutionary advantage that selected this kind of defensive mechanism.…”

Section: Introductionmentioning

confidence: 99%

“…12 During conservative treatment 10-20% are not resolved. [1][2][3]13 Failure of conservative regime occurs in 2-4% cases where urgent exploration is essential. 14 The Appendicular mass is more commonly seen amongst young adult males.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Evaluation of outcome of early appendectomy in appendicular lump

Haque

Saha

Haque

et al. 2020

Int J Contemp Pediatr

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Background: Appendicular lump is a well-known sequalae of acute appendicitis encountered in 2-6% of patients. Successful management of appendicular lump is controversial with different approaches. This study aims to evaluate the outcome of early appendectomy in an appendicular lump.Methods: A total of 210 patients were admitted in surgery and pediatric surgery department of Rangpur medical college and hospital with the diagnosis of acute appendicitis and its sequalae over two years.Results: In this study, sixty patients were included who were presented with an appendicular lump. Maximum patients (50%) were found in the age group of 21-30 years. Males (66.67%) were more affected. Eighty percent of patients were coming from below-average socio-economic conditions. In group I, early appendicectomy had done and outcomes were satisfactory and favorable. In group II, eighteen patients were operated who were admitted at 6 to 8 days after an attack of acute appendicitis, and twelve patients were continued the conservative treatment. In group II, who had done surgery, among them, fourteen patients (77.78%) were found an appendicular abscess, and four patients (22.22%) were found perforated appendix per-operatively. In group I, the mean recovery period was less and they had minimum complications. In group II, the mean recovery period was more and they had more complications.Conclusions: Based on these findings, it can be concluded that early exploration in appendicular lump patients confirm the diagnosis, cures the problem, reduces the cost of management, and shortens the convalescence period and hospital stay with reasonably satisfactory outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of outcome of early appendectomy in appendicular lump

Haque

Saha

Haque

et al. 2020

Int J Contemp Pediatr

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Early versus delayed appendicectomy for appendiceal phlegmon or abscess

Zhou,

Cheng,

Cheng

et al. 2024

Cochrane Database of Systematic Reviews

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Early Surgical Management of Appendicular Mass: Evaluation of Surgical Outcome in Selected Private and Government Hospitals, Bangladesh

Sarwar,

Shamsuddin,

Munira

2024

CMR

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Background: Appendicular mass, a common occurrence in acute appendicitis (10% of cases), develops within 24-48 hours of symptom onset. Management strategies, including early appendectomy, non-operative management with or without drainage, and interval appendectomy, vary widely. This study aims to evaluate the outcomes of early surgical management and compare different surgical approaches. Methodology: This retroospective observational study was performed in different private and government hospital at Jamalpur, Manikgonj for a period of 8 years from January 2015 to December 2022. A total of 288 consecutive patients meeting eligibility criteria underwent open appendectomy within 24 hours of hospital admission due to appendicular lump diagnosis based on clinical or ultrasonographic findings. Two surgical techniques were employed: appendicectomy with generalized peritoneal toileting and appendicectomy with loco-regional peritoneal toileting All data were collected from hospital records. Follow-up records for a period of 2 weeks and at the end of 1 year were reviewed. Results: Patients had a mean age of 30.04 years, mostly male and under 30 years old. Appendicular lump with abscess was predominant (73.96%), along with perforated appendix and presence of pus (71.18% and 75.35% respectively). 68.75% underwent appendicectomy with loco-regional toileting, and 31.25% with generalized peritoneal toileting. Both groups were similar in demographics and perioperative findings, with common difficulties in localization and dissection (76.79% and 88.89% respectively). No bowel injuries occurred in the loco-regional toileting group. Postoperative complications were significantly lower in this group, especially superficial and deep wound infections (11.61% vs 16.67%, 2.53% vs 10%). Fecal fistula and incisional hernia were observed in the generalized peritoneal toileting group (1.11%, 2.22%). Operative time was notably shorter in the loco-regional peritoneal toileting group (92 minutes vs 65 minutes) Conclusion: Early appendicectomy allows for single-admission treatment, serving as an effective alternative to conservative therapy by significantly reducing hospital stays and expenses. Specifically, early appendicectomy with loco-regional peritoneal toileting demonstrates shorter operative times and lower post-operative complications compared to generalized peritoneal toileting, suggesting its favorable utility in managing appendicular mass and warranting further optimization in surgical strategies.

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A comparative study of appendicular lump management

Cited by 12 publications

References 7 publications

Evaluation of outcome of early appendectomy in appendicular lump

Evaluation of outcome of early appendectomy in appendicular lump

Early versus delayed appendicectomy for appendiceal phlegmon or abscess

Early Surgical Management of Appendicular Mass: Evaluation of Surgical Outcome in Selected Private and Government Hospitals, Bangladesh

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