Laparoscopic Appendectomy with Appendix Mass in Children

Abstract

Laparotomy for complicated appendicitis with a mass has been the traditional approach in the presence of acute lower abdominal pain, generalized peritonitis, and fever. Generous right iliac fossa incisions are routinely done to deal with these cases, as the appendectomy can be difficult due to visceral adhesion, omental wrapping, and early abscess formation within the mass. Laparoscopic appendectomy can result in decreased pain due to smaller wounds, as well as providing superior cosmesis. In a two-year study, 11 patients with appendicular masses were treated by laparoscopy. The procedure took an average of 120 ± 20 min. All patients were ambulatory within 2 days. Hospital stay postsurgery was an average of 6 days. There was a single minor umbilical wound infection. Laparoscopic appendectomy can be recommended even in the presence of a preoperatively diagnosed appendicular mass and/or abscess. It does take longer than an open procedure, while cosmesis is superior and postoperative pain is less.