Abstract

Acute appendicitis is the most common surgical emergency which may be complicated by development of an appendiceal mass. An appendiceal mass varies from phlegmon to abscess and develops in 2-6% of cases following acute appendicitis. Three modes of management are practiced 1.immediate appendectomy before resolution of mass 2.Conservative management with interval appendectomy 3.Entirely conservative approach without interval appendectomy with regular follow up. Ochsner Sherren regimen is followed for conservative management of appendiceal mass. Aim of the Study: To study that outcome of appendicular mass patients on conservative management followed by interval appendectomy (Group 1) against conservative management alone with regular follow up (Group 2).To evaluate that risks of interval appendicectomy. Materials and Methods: Prospective observational study was conducted for 50 patients admitted with acute appendicitis during the study period from March 2021 to October 2022. All the patients were subjected to detailed clinical examination, laboratory investigations and radiological imaging with their consent. Results: The mean age group was similar in both groups (26 to 50yrs), so there was no statistical significance. Males were more affected than females. In conservatively managed group 2 patients developed complications and the other group 9 patients developed complications. Among 25 patients in 1st group 4 got recurrent appendicitis and in interval appendectomy 9 patients got recurrent appendicitis. In the 1st group 22 patients stayed in hospital for <5 days and 3 patients 5-10 days. In the 2nd group 9 patients stayed in hospital for < 5 days,13 patients for 5-10 days and 3 patients for >10days. The P value was significant in this group. Conclusion: Early appendectomy is the treatment of choice in acute appendicitis. In the management of appendiceal mass following conservative management, interval appendectomy vs conservative management alone with regular follow up is still debatable. Recent studies in literature are mostly not in favour of routine interval appendectomy following conservative management. In this study the complication rate, duration of hospital stays more in interval appendectomy group so we conclude it is better to go for conservative management with regular follow up and intervene when recurrence occurs in case of appendiceal mass.

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