Recurrent appendicitis after initial conservative management of appendiceal abscess

Price, Mitchell R.; Haase, Gerald M.; Sartorelli, Kennith H.; Meagher, David P.

doi:10.1016/s0022-3468(96)90018-4

Cited by 44 publications

(37 citation statements)

References 8 publications

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“…Oral food intake is restarted and extended when pain and size of the palpable mass decrease, using ultrasound examination and erythrocyte sedimentation rate (ESR) as methods for follow-up of the mass [4, 5]. An elective appendectomy is performed in the majority of centres approximately 8 weeks after the acute episode [6, 7, 8, 9, 10, 11]. During the past years we have followed this approach; however, in recent years more evidence is presented in the literature that this interval appendectomy can be omitted [3, 23].…”

Section: Introductionmentioning

confidence: 99%

The Need for Interval Appendectomy after Resolution of an Appendiceal Mass Questioned

Willemsen¹,

Hoorntje

Eddes

et al. 2002

Dig Surg

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Background: Our current treatment of an appendiceal mass is initially conservative, followed by an interval appendectomy. The necessity of this routine interval appendectomy is debatable. A study was conducted to evaluate whether surgical factors and pathological features of the excised appendices support interval appendectomy. Methods: We performed a retrospective study at the University Hospital Groningen and the Deventer Ziekenhuis. All patients diagnosed with an appendiceal mass in the period January 1991 to January 1997 were identified using the hospital database. The medical records of all these patients (n = 233, 108 M, 125 F) were reviewed. The clinical course of the appendiceal mass patients was split up into three distinct episodes: initial diagnosis and treatment of the appendiceal mass, the interval period and the interval appendectomy. Presenting symptoms, findings at clinical examination and additional imaging (ultrasound) were registered, as well as the course of the primary hospitalisation, the interval period, and the interval appendectomy. Results of histological examination of all resected specimens were reviewed. Results: It was found that clinical findings alone were not specific enough to diagnose an appendiceal mass; 47% had a palpable abdominal mass and the median temperature was 38.2°C ranging from 36 to 40.5°C. Ultrasound examination was done in 69% of patients and showed an appendiceal mass in 72%. During the interval period, 4 patients presented with an appendiceal mass needing drainage, and 3 with acute appendicitis requiring emergency appendectomy. At interval appendectomy, histological examination of resection specimen showed a normal appendix without signs of previous inflammation in 30% of cases. In addition, complications due to interval appendectomy were seen in 18% of patients, including sepsis, bowel perforation, small bowel ileus, and various wound abscesses. Conclusions: We conclude that when causes for the appendiceal mass other than appendicitis are excluded, interval appendectomy seems unnecessary in patients who respond well to initial conservative treatment.

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Section: Introductionmentioning

confidence: 99%

The Need for Interval Appendectomy after Resolution of an Appendiceal Mass Questioned

Willemsen¹,

Hoorntje

Eddes

et al. 2002

Dig Surg

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show abstract

“…This is the most commonly practiced treatment for an appendicular mass without abscess formation (Price MR 1996). It is favoured because it can avoid the potential hazards of damage to the caecum and the development of faecal fistula (Nitecki S 1993) , (Norman S William).…”

Section: Advocates Of the Conventional Treatmentmentioning

confidence: 99%

Recent Trends in the Treatment of the Appendicular Mass

Malik¹,

Shaikh²

2012

Appendicitis - A Collection of Essays From Around the World

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“…In the abdomen, appendicitis is the most common etiology of an abscess, and it may present before or after surgery [1][2][3][4][5][6][7][8]. Other etiologies for abdominal collections include cerebrospinal fluid pseudocysts ( Fig.…”

Section: Aspiration and Drainagementioning

confidence: 99%

“…2 and 3) [1][2][3][4][5][6][7][8]25]. When using transrectal access, a trocar technique may be used as it protects the patient and radiologist from the sharp needle tip [3,7,8].…”

Section: Aspiration and Drainagementioning

confidence: 99%