Appendicular mass, early exploration vs conservative management

ABSTRACT

Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. A comparison of conservative treatment versus early surgical exploration of appendicular mass. Experimental study. Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I [Early exploration] and group II [Conservative treatment] each containing 30 patients. A comparison of outcome between two groups was done statistically by applying student Chi-square test. There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 21. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admission were less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Early surgical exploration of appendicular mass is safe and cost effective