Interval appendectomy: surgical and pathological basis

ABSTRACT

The treatment of appendiceal mass is controversial. For patients initially treated conservatively with antibiotics with or with out drainage, the role of interval appendectomy is an area of considerable debate. To evaluate the indications of interval appendectomy in patients presented with appendicular mass in correlation with post operative histopathological results. This is a prospective study of 97 cases with the diagnosis of appendicular mass admitted and treated conservatively in Baghdad Teaching Hospital during the period from December 2002 to December 2006 then scheduled for interval appendectomy. .Histopathology of the appendix examined and correlation of the result with certain clinical characteristic of the patients. The prevalent age group was 30-39 years [39%] and male to female ratio was 2.81. Postoperative histopathological features of the excised specimens showed that 85/97 [88%] of patients had chronically fibrosed appendix with obliterated lumen. The remaining 12/97 [12%] of patients were having inflamed appendices. There was a clear correlation the age of patient above 40 years [41%]and initial clinical response [94%] with the histopathologic support for appendectomy. Interval appendectomy was mandatory in the following groups of patients Patients >/= 40 years old. Patients with poor initial response to conservative treatment. Patients with recurrent symptoms. Patients with WBC count >/= 12000 cell/cc