Management of Appendiceal Mass and Abscess. An 11-Year Experience

Abstract

The aim of our study is to compare the results of emergency surgery versus conservative treatment with interval surgery in patients diagnosed with appendiceal mass and abscess. A retrospective review of 48 patients with appendiceal mass and abscess treated from January 2002 to January 2013 at General Surgery Department of Kipshidze Central University Hospital was performed. Patients with emergency surgery were compared to patients treated by nonoperative management with interval surgery. Demographics, clinical profile, and operative outcomes were studied. The emergency surgery group included 25 patients, and the interval surgery group included 23 patients. The clinical characteristics of the emergency surgery and interval surgery groups were not statistically different. In the emergency surgery group, an open appendectomy was performed on 17 patients, and colonic resections (ileocecectomy or right hemicolectomy) were performed on 8 patients. In the interval surgery group, an open appendectomy was performed on 21 patients, and colonic resections were performed on 2 patients. There were no statistical differences in types of surgery, postoperative complications, operation time without colonic resections, and postoperative hospitalization period among these 2 groups. Operation time with colonic resections was of greater duration in the emergency surgery group than in the interval surgery group (P ¼ 0.04). Both treatment methods for appendiceal mass and abscess have the same results. The surgeon must consider clinical symptoms and results of investigations in each particular case when choosing an appropriate treatment method. Prospective randomized controlled trials are required for comparing the results of all 3 treatment methods of appendiceal mass.

Ectopic kidney mimicking appendicular abscess

“…Although ultrasonogram with a sensitivity of 88% and specificity of 94% is sufficient to diagnose acute appendicitis, atypical presentation or suspicion of associated genitourinary pathologies warrants a contrast-enhanced computed tomography. [ 4 ]…”

The feasibility of interval laparoscopic appendectomy and appropriate patient selection: A retrospective study of adult appendiceal masses

“…Research has shown that when surgery for AM is performed without nonsurgical treatment, surgical complications increase due to edema and the vulnerability of the adjacent small and large intestine; additionally, there may be difficulty in approaching the appendix because of deformation of the anatomic structures and location 26 . In a recent study of 49 patients who completed ILA from a cohort of 64 appendiceal abscess patients in Japan, blood loss, the need for extended resection, and overall postoperative morbidity were found to be significantly lower than in the emergency group, even though the total hospitalization cost was higher 27 .…”

The effectiveness and appropriateness of Interval Laparoscopic Appendectomy on adult appendiceal mass, a retrospective cohort

“…By comparing the ILA group and the non-ILA group, it was clear that the ILA procedures were less invasive and easier postoperative management than the non-ILA group. When surgery is performed without non-surgical treatment for AM, surgical complications increase due to the edema, vulnerability of the adjacent small and large intestine, as well as difficulty in approaching the appendix due to deformation of the anatomic structures and location [26]. In order to avoid extended resection and perioperative complications, non-surgical treatment should be completely fulfilled.…”