Comparative study of outcome of conservative versus operative management in 50 cases of appendicular lump

Abstract

Background: To compare the different modes of management of appendicular lump whether traditional emergency operation or conservative management. Objective: To evaluate the outcome of emergency surgery versus conservative management in patients with complicated appendicitis with appendicular lump/abscess undergoing interval appendectomy. Materials and Methods: This is a prospective observational study of total 50 cases of complicated appendicitis with appendicular lump/abscess. A total of 18 patients were treated for emergency operations and rest were treated conservatively with antibiotics alone (n = 26) and antibiotics with percutaneous drainage (n = 6). Twenty-four patients who were initially treated conservatively, underwent planned interval operations later. Result: The mean age of the patients was 50.8 years, and the ratio of men to women was 27:23. Among them, the emergency surgery group included 18 patients (36%) and the conservative treatment group included 32 patients (64%). Duration of symptoms was 7 days in group 1 compared to 9 days in group 2. White blood cells (WBCs) count was similar in both groups. During emergency surgery, three patients (15%) require resection, whereas none underwent in planned group. Duration of surgery was 115 and 100 min in emergency and planned groups, respectively. The complication rate was higher (almost twice) in emergency group compared to planned group. The hospital stay was 12 and 9 days in emergency and planned groups, respectively. Conclusion: The results of this study state that appendicitis complicated with an abscess or mass could be treated safely and effectively by initially using conservative management.