Abstract
Background: Acute Appendicitis is one of the most common acute surgical conditions of the abdomen and appendicular lump is formed if treatment is delayed. Appendicular mass is one of its early complications developing in 2-6% cases within48 hours of attack. The traditional treatment of appendicular lump is conservative followed by delayed appendectomy. During conservative treatment 10-20% is not resolved and leads to gangrene or perforation followed by localized abscess or generalized peritonitis requiring early surgical intervention.
 Aim and Objective: To evaluate the outcome of early surgical exploration and its complications in respect to conservative management of appendicular lump.
 Material and Methods: Total of 48 patients admitted with diagnosis of appendicular lump were included in our study. This prospective study was conducted in Department of General Surgery of Index Medical College, Hospital and Research Centre, Indore, M.P over period of 2 years [August 2019 to July 2021] in all age group and both sexes.
 All cases were divided randomly into two groups. Group I, early surgical exploration and Group II, conservative approach with OCHSNER SHERREN REGIME followed by interval appendectomy after 6 weeks.
 Results: Total 471 patients admitted to hospital with diagnosis of acute appendicitis, out of which total 48 patients were having Appendicular lump suggestive of incidence of 9.81%. Maximum patients were found in age group 21-30 years. Average duration of symptoms was 2 days. Two methods were adopted for the management of appendicular lump. The first group included 24 patients who were operated immediately after investigations and second group of 24 patients were managed conservatively followed by delayed appendectomy. In the first group mean hospitalization time was 4 days. Residual abscess, adhesive intestinal obstruction, failure of treatment and readmission were not found. In the group II, mean hospitalization time 10 days, more chances of residual abscess, adhesive intestinal obstruction, failure of treatment and readmissions were noted.
 Conclusion: In our study, it can be concluded that early surgical exploration confirms diagnosis and cures the problem, reduce the cost of management, shortens the convalescence and hospital stay with reasonably satisfactory outcome.
 Key-Words: Appendicular Lump, Ochsner-Sherren Regime Appendectomy.
Highlights
Acute Appendicitis is the commonest cause of “acute surgical abdomen”
Group I, early surgical exploration and Group II, conservative approach with OCHSNER SHERREN REGIME followed by interval appendectomy after 6 weeks
Exclusion Criteria: Any patients whose diagnosis was changed after initial diagnosis was changed after initial diagnosis of appendicular lump were excluded from the study
Summary
Acute Appendicitis is the commonest cause of “acute surgical abdomen”. The definitive treatment of acute appendicitis is appendicectomy. The conventional conservative treatment followed by delayed appendectomy in patients with appendicular mass is well recommended. 7-46% of the patients suffer a recurrence of acute appendicitis or appendicular mass following discharge from the hospital after successful conservative treatment of appendicular mass In the modern era where facilities and expertise of laparoscopic surgery is available, laparoscopic appendicectomy for both complicated (appendicular lump) and uncomplicated appendicitis is recommended where possible which further lessens morbidity Based on these studies, the present study was done with objective of comparison of early exploration versus conservative management of appendicular lump. In the group II, mean hospitalization time 10 days, more chances of residual abscess, adhesive intestinal obstruction, failure of treatment and readmissions were noted.
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