E-ISSN 2277-338X | ISSN 2320-4664
 

Original Research 


Management of Appendicular Lump: Early exploration Vs conservative management

Chandra Prakash Pandey, Ram Chandra Kesharwani, Chandra Gopal Singh Chauhan, Manmohan Krishna Pandey, Purnima Mittra, Pramod Kumar, Arshad Raza.

Abstract
Background: Acute appendicitis is one of the most common acute surgical condition of the abdomen and appendicular lump is formed if treatment is delayed. It is encountered in 2 6%of patients. The traditional treatment of appendicular lump is conservative followed by delayed appendectomy. During conservative treatment 10-20% are not resolved and lead to gangrene or perforation followed by localized abscess or generalized peritonitis requiring early surgical intervention.

Aims & Objective: A comparison of early exploration versus conservative management of appendicular lump.

Material and Methods: A total of 632 patients were admitted in emergency and OPD of this hospital with diagnosis of appendicular lump and acute appendicitis over a period of three years, all were included in the study. All age groups and both sexes were included. The patients were divided randomly into two groups. Group I, early surgical exploration and group II, conservative approach with OCHSNER SHERREN, REGIME followed by interval appendectomy.

Results: Out of 632 patients, only 62 patients who presented with appendicular lump were reviewed, suggesting 9.81% incidence. Maximum patients were found in age group of 2130 years. Average duration of symptoms was 4 days. Two methods were adopted for the management of appendicular lump. The first group included 31 patients who were operated immediately after investigations and second group of 31 patients were managed conservatively followed by delayed appendectomy. In the first group mean hospitalization time was 4 days. Residual abscess, adhesive intestinal obstruction, failure of treatment and readmission were not observed. In the II group mean hospitalization time 10 days, more chances of residual abscess, adhesive intestinal obstruction, failure of treatment and readmissions were noted.

Conclusion: Based on our finding, it can be concluded that early surgical exploration confirms the diagnosis and cures the problem, reduce the cost of management, shortens the convalescence and hospital stay with reasonably satisfactory outcome.

Key words: Appendicitis, Appendicular lump, Appendectomy


 
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REFERENCES
1. Ali S, Rafique HM. Appendicular mass; Early exploration vs conservative management. Professional Med J Jun. 2010;17(2):180-4.
2. Jordan JS, Kovalcik PJ, Schwab CW. Appendicitis with a palpable mass. Ann Surg. 1981;193(2):227-9. [DOI via Crossref]   
3. Wade DS, Marrow SE, Balsara ZN, Burkhard TK, Goff WB. Accuracy of ultrasound in the diagnosis of acute appendicitis compared with the surgeon's clinical impression. Arch Surg. 1993;128(9):1039-44. [DOI via Crossref]   
4. O'Connell PR. The Verniform apprndix. In: Williams NS, Bullstrode CJK, O'Connell PR, (editors). Bailey and Love's Short practice of surgery. 25th edi. London: Hodder Arnold. 2008. p. 1204-18.
5. Eryilmaz R, Sahin M, Savaþ MR. Is interval appendectomy necessary after conservative treatment of appendiceal masses? [Article in Turkish]. Ulus Travma Acil Cerrahi Derg. 2004;10(3):185-8.
6. Oliak D, Yamini D, Udani VM, Lewis RJ, Vergas H, Arnell T, et al. Non-operative management of perforated appendicitis without periappendiceal-mass. Am J Surg. 2000;179(3):177-81. [DOI via Crossref]   
7. Garg P, Dass BK, Bansal AR, Chitkara N. Comparative evaluation of conservative management versus early surgical intervention in appendicular mass. J Indian Med Assoc. 1997;95(6):179-80.
8. Arshad M, Aziz LA, Qasim M, Talpur KAH. Early appendectomy in appendicular mass. JAMC 20(1):70-2.
9. Taj MH, Qureshi SA. Early surgical management of appendicular mass; J Surg Park. 2006;11(2):52-6.
10. Senapathi PS, Bhattacharya D, Ammori BJ. Early laparoscopic appendectomy for appendicular mass. Surg Endosc 2002;16(12):1783-5. [DOI via Crossref]   
11. William RCN, Whitelaw DE. General surgical operations. 1st ed. UK: Elsevier Books Customer Service. 2006. p. 111.

How to Cite this Article
Pubmed Style

Pandey CP, Kesharwani RC, Chauhan CGS, Pandey MK, Mittra P, Kumar P, Raza A. Management of Appendicular Lump: Early exploration Vs conservative management. Int J Med Sci Public Health. 2013; 2(4): 1046-1049. doi:10.5455/ijmsph.2013.230820131


Web Style

Pandey CP, Kesharwani RC, Chauhan CGS, Pandey MK, Mittra P, Kumar P, Raza A. Management of Appendicular Lump: Early exploration Vs conservative management. http://www.ijmsph.com/?mno=41037 [Access: September 20, 2018]. doi:10.5455/ijmsph.2013.230820131


AMA (American Medical Association) Style

Pandey CP, Kesharwani RC, Chauhan CGS, Pandey MK, Mittra P, Kumar P, Raza A. Management of Appendicular Lump: Early exploration Vs conservative management. Int J Med Sci Public Health. 2013; 2(4): 1046-1049. doi:10.5455/ijmsph.2013.230820131



Vancouver/ICMJE Style

Pandey CP, Kesharwani RC, Chauhan CGS, Pandey MK, Mittra P, Kumar P, Raza A. Management of Appendicular Lump: Early exploration Vs conservative management. Int J Med Sci Public Health. (2013), [cited September 20, 2018]; 2(4): 1046-1049. doi:10.5455/ijmsph.2013.230820131



Harvard Style

Pandey, C. P., Kesharwani, R. C., Chauhan, C. G. S., Pandey, M. K., Mittra, P., Kumar, P. & Raza, A. (2013) Management of Appendicular Lump: Early exploration Vs conservative management. Int J Med Sci Public Health, 2 (4), 1046-1049. doi:10.5455/ijmsph.2013.230820131



Turabian Style

Pandey, Chandra Prakash, Ram Chandra Kesharwani, Chandra Gopal Singh Chauhan, Manmohan Krishna Pandey, Purnima Mittra, Pramod Kumar, and Arshad Raza. 2013. Management of Appendicular Lump: Early exploration Vs conservative management. International Journal of Medical Science and Public Health, 2 (4), 1046-1049. doi:10.5455/ijmsph.2013.230820131



Chicago Style

Pandey, Chandra Prakash, Ram Chandra Kesharwani, Chandra Gopal Singh Chauhan, Manmohan Krishna Pandey, Purnima Mittra, Pramod Kumar, and Arshad Raza. "Management of Appendicular Lump: Early exploration Vs conservative management." International Journal of Medical Science and Public Health 2 (2013), 1046-1049. doi:10.5455/ijmsph.2013.230820131



MLA (The Modern Language Association) Style

Pandey, Chandra Prakash, Ram Chandra Kesharwani, Chandra Gopal Singh Chauhan, Manmohan Krishna Pandey, Purnima Mittra, Pramod Kumar, and Arshad Raza. "Management of Appendicular Lump: Early exploration Vs conservative management." International Journal of Medical Science and Public Health 2.4 (2013), 1046-1049. Print. doi:10.5455/ijmsph.2013.230820131



APA (American Psychological Association) Style

Pandey, C. P., Kesharwani, R. C., Chauhan, C. G. S., Pandey, M. K., Mittra, P., Kumar, P. & Raza, A. (2013) Management of Appendicular Lump: Early exploration Vs conservative management. International Journal of Medical Science and Public Health, 2 (4), 1046-1049. doi:10.5455/ijmsph.2013.230820131





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