Muhammad Ayub Jat, Muhammad Rafique Memon, Saima Arshad, Ali Gohar Bozdar, Roshan Ali Solangi.
Study of early surgical intervention in appendicular mass.
Gomal J Med Sci Jan ;10(1):50-3.
Background: Acute appendicitis may complicate to appendicular mass. It is conventionally treated conservatively followed by interval appendicectomty. This study was conducted to determine the feasi-bility and safety of early appendicectomy in patients with appendicular mass. Methods: This compara-tive study was conducted at Department of Surgery, Unit-I, Ghulam Muhammad Maher Medical College Teaching Hospital, Sukkur, from July 2008 to June 2011. Sixty patients with appendicular mass were in-cluded. They were divided into two groups, A & B with 30 patients each regardless of age and sex. Early appendicectomy was performed in group A within 24 hours of admission while group B patients were managed conservatively followed by interval appendicectomy. Evaluation included operative and post-operative complications, operation time, and total hospital stay. Results: Out of 60 patients, 40 were males and 20 females, with male to female ratio of 2:1. Age range was 12-50 years, mean 24+9.25 years. Early surgical intervention was done in 30 patients. In these appendicular mass without pus formation was de-tected in 24(80%), localized pus collection along with mass in 4(13.33%) and frank appendicular abscess in 2(6.66%) patients. Mean hospital stay was 4.50±4.86 days. Post-operative complications such as superfi-cial wound infection occurred in 5(16.66%), deep wound infection in 3(10%), incisional hernia in 1(3.33%) and faecal fistula in 1(3.33%) patient. Two (6.66%) cases of residual abscess were found in this study man-aged by antibiotics and ultrasound guided drainage. Treatment failure by conservative means, patient compliance, readmission and overall expenses were main limitations in group B patients. Conclusion: Early surgical intervention in patients with appendicular mass is feasible and safe as compared to conserva-tive approach.
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