Comparative analysis of early exploration versus conservative approach for management of appendiceal mass

Abstract

Background: Acute appendicitis is the most common reason for emergency abdominal surgery. Acute appendicitis is ranging from mild inflammation of mucous membrane to gangrene, perforation and peritonitis. Appendicular mass is one of its early complication developing in 2 to 6 % cases of acute appendicitis within 48 hours of attack. Objective of this study was to evaluate the outcome of early surgical exploration and its complications in respect to conservative management followed by interval appendectomy for the management of appendicular mass.Methods: A total 46 cases with clinical feature suggestive of appendicular mass presenting in MLN Medical college, Allahabad were included in study. All cases divided into two equal groups based on mode of management of appendicular mass. Group I (early exploration) and Group II (conservative followed by interval appendectomy).Results: Result will be analysed in terms of hospital stay, morbidity, complications and cost.Conclusions: Early exploration for appendicular mass had advantages of total curative treatment in the index admission, shorter hospital stay, minimal morbidity and ensures early return to work and higher compliance. Operative problems such as localization of appendix, adhesiolysis and bleeding are more pronounced and troublesome with interval appendectomy. Wound infection remains common postoperative complication of early appendectomy in appendicular mass but the rate of wound infection is not so high as to preclude this early operative approach.