Is it Possible to Manage Appendicular Mass Without Surgery?
DOI:
https://doi.org/10.54133/ajms.v9i2.2322الكلمات المفتاحية:
Acute appendicitis، Appendicular mass، Appendectomy، Conservative managementالملخص
Background: Three ways are available to manage appendicular mass; two of them include surgical intervention. The third approach is conservative treatment and follow-up without interval appendectomy. Objective: To evaluate the outcome of conservative treatment for the appendicular mass and to assess the incidence of acute appendicitis in those patients. Methods: In a study, 98 patients with appendicular mass were divided into two groups. Group A, consisting of 55 patients, was treated with conservative management without appendectomy, while Group B, consisting of 43 patients, was treated with conservative treatment followed by interval appendectomy 8 weeks later. For Group A, the mass was monitored via ultrasound examination every 3-5 days until it subsided, which took 12-25 days. Group B had two admission periods, initially and after the interval. Results: The study found that appendicular mass occurred frequently in patients aged 21–30 in both groups, and there were no significant differences in age and gender between group A and group B. The resolving time of appendicular mass and the duration of the symptom were also not significantly different between the two groups. However, there was a significant difference between Group A and Group B in terms of overall hospitalization time, with Group B having two admission periods. Conclusions: Conservative management, without interval appendectomy, is the preferred method for treating appendicular mass due to the low incidence of acute appendicitis recurrence. This method can avoid unnecessary surgical intervention and associated complications.
التنزيلات
المراجع
Mulson J. The vermiform appendix. In: O’Connell PR, McCaskie AW, Sayers RD, (eds.), Bailey and loves short practice of surgery, (28th ed.) Taylor & Francis Group; 2023. P. 1335-53. DOI: https://doi.org/10.1201/9781003106852-87
Rahman MA, Chowdhury TK, Chowdhury MZ, Farooq MA. Early appendectomy for appendicular mass: operative findings and outcome in 220 children—a developing country perspective. Ann Pediatric Surg. 2020;16(39):1-5. doi: 10.1186/s43159-020-00051-x. DOI: https://doi.org/10.1186/s43159-020-00051-x
Dixon F, Singh A. Acute appendicitis. Surgery (Oxford). 2020;38(6):310-317. doi: 10.1016/j.mpsur.2020.03.015. DOI: https://doi.org/10.1016/j.mpsur.2020.03.015
van Amstel P, Sluckin TC, van Amstel T, van der Lee JH, de Vries R, Derikx JPM, et al. Management of appendiceal mass and abscess in children; early appendectomy or initial non-operative treatment? A systematic review and meta-analysis. Surg Endosc. 2020;34(12):5234-5249. doi: 10.1007/s00464-020-07822-y. DOI: https://doi.org/10.1007/s00464-020-07822-y
Tarar B, Batool S, Majeed S, Saleem A, Tarar B. Comparison between early appendectomy vs. conservative management in cases of appendicular mass. Cureus. 2023;15(4). doi: 10.7759/cureus.37986. DOI: https://doi.org/10.7759/cureus.37986
Rajah KH, Menon S. Complicated appendicitis-shifting towards early appendectomy-A comprehensive review. IIUM Med J Malaysia. 2024;23(01). doi: 10.31436/imjm.v23i01.2372. DOI: https://doi.org/10.31436/imjm.v23i01.2372
Rajah KH, Menon S, Ramachandran G. Current management of appendicular mas-a narrative. Med J Malaysia. 2023;78(5):669. PMID: 37775496.
Zeb M, Khattak SK, Samad M, Shah SS, Shah SQ, Haseeb A. Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis. Heliyon. 2023;9(1). doi: 10.1016/j.heliyon.2023.e13013. DOI: https://doi.org/10.1016/j.heliyon.2023.e13013
López CD, Sánchez LA, Vázquez JM, Salinas RE, Sánchez JJ, López IE, et al. Early surgery in appendicular mass: Surgical technique and morbidity. Int J Sci Acad Res. 2023;4(4):5513-5518.
Koirala A, Thakur D, Agrawal S, Pathak KR, Bhattarai M, Sharma A. Appendicular mass: a conservative approach. J Nobel Med Coll. 2016;5(2):47-50. doi: 10.3126/jonmc.v5i2.16317. DOI: https://doi.org/10.3126/jonmc.v5i2.16317
Israr S, Akhtar J, Taqvi SM, Zamir N. Early surgical management of appendicular mass in pediatric patients. J Coll Physicians Surg Pak. 2021;31(3):302-306. doi: 10.29271/jcpsp.2021.03.302. DOI: https://doi.org/10.29271/jcpsp.2021.03.302
Almoamin HH. Factors affecting the effectiveness of conservative management of appendicular mass. Polish J Surg. 2021;93(3):17-21. doi: 10.5604/01.3001.0014.8132. DOI: https://doi.org/10.5604/01.3001.0014.8132
Appa SK, Kumar KK, Vuppala C. Appendicular mass: early or interval appendicectomy. Int J Acad Med Pharm. 2023;5(1):787-793. doi: 10.47009/jamp.2022.5.1.164.
Takahashi Y, Obata S, Matsuura T, Kawano Y, Yanagi Y, Yoshimaru K, et al. The experiences of interval appendectomy for inflammatory appendiceal mass. Pediatrics Int. 2021;63(1):88-93. doi: 10.1111/ped.14358. DOI: https://doi.org/10.1111/ped.14358
Hayes D, Reiter S, Hagen E, Lucas G, Chu I, Muñiz T, et al. Is interval appendectomy needed? A closer look at neoplasm rates in adult patients undergoing interval appendectomy after complicated appendicitis. Surg Endoscopy. 2021; 35:3855-3860. doi: 10.1007/s00464-020-07798-9. DOI: https://doi.org/10.1007/s00464-020-07798-9
Son J, Park YJ, Lee SR, Kim HO, Jung KU. Increased risk of neoplasms in adult patients undergoing interval appendectomy. Ann Coloproctol. 2020;36(5):311. doi: 10.3393/ac.2019.10.15.1. DOI: https://doi.org/10.3393/ac.2019.10.15.1
Al-Atta DM, Al-Samarraee MF, Fadhil AA, Kadhim ST, Alsarhan HW. Compliance with second visit of diabetes mellitus screening program and impact of dietary and exercise modification on glycemic control. Al-Rafidain J Med Sci. 2025;8(2):150-156. doi: 10.54133/ajms.v8i2.1929. DOI: https://doi.org/10.54133/ajms.v8i2.1929
Fouad D, Kauffman JD, Chandler NM. Pathology findings following interval appendectomy: Should it stay or go? J Pediatric Surg. 2020;55(4):737-741. doi: 10.1016/j.jpedsurg.2019.05.001. DOI: https://doi.org/10.1016/j.jpedsurg.2019.05.001
Janakiraman R. A prospective comparative study of interval appendicectomy vs conservative management with follow-up in appendiceal mass in GRH Madurai. IOSR J Dent Med Sci. 2020;19(11):34-40. doi: 10.9790/0853-1911033440.
Yılmaz Y, Kamer E, Acar N, Etlik MN, Güngör H, Kar H, et al. Approach to appendiceal masses due to acute appendicitis: Analysis of 126 cases. Turk J Colorectal Dis. 2020;30(2):134-137. doi: 0.4274/tjcd.galenos.2020.2020-2-5. DOI: https://doi.org/10.4274/tjcd.galenos.2020.2020-2-5
Memon ZA, Khowaja MA, Zardari IA, Ghumro AH, Dahri FJ, Soomro IA. Comparison of early appendectomy versus conservative management for appendicular lump at tertiary care hospital. Professional Med J. 2020;27(09):1818-1822. doi: 10.29309/TPMJ/2020.27.09.3961. DOI: https://doi.org/10.29309/TPMJ/2020.27.09.3961
Tekin A, Kurtoğlu HC, Can I, Öztan S. Routine interval appendectomy is unnecessary after conservative treatment of appendiceal mass. Colorectal Dis. 2008;10(5):465-468. doi: 10.1111/j.1463-1318.2007. DOI: https://doi.org/10.1111/j.1463-1318.2007.01377.x
Mani V, Chejara R, Arya SV, Bhatia A, Chaudhary R, Raj M. Evaluation of conservative management in uncomplicated acute appendicitis. Int J Res Med Sci. 2021;9(9):2618. doi: 10.18203/2320-6012.ijrms20213179. DOI: https://doi.org/10.18203/2320-6012.ijrms20213179
Qureshi AG, Idris SA. The study of non-operative treatment for acute appendicitis (NOTA). Saudi J Med. 2020;5(1):11-15. doi: 10.36348/sjm.2020.v05i01.003. DOI: https://doi.org/10.36348/sjm.2020.v05i01.003
Alsubsiee IFN, Alsubsiee AFN. Appendicectomy for uncomplicated simple appendicitis: Is it always required? Surg Res Pract. 2021;2021. doi: 10.1155/2021/8848162. DOI: https://doi.org/10.1155/2021/8848162
Khaja A, Khaleel MI. A study on treatment option for appendicitis-conservative vs surgical methods and its outcomes with Alvarado score of five. Int J Adv Res Med. 2019;1(2):112-114. doi: 10.22271/27069567.2019.v1.i2b.99. DOI: https://doi.org/10.22271/27069567.2019.v1.i2b.99
Bemelman WA, Warusavitarne J, Sampietro GM, Serclova Z, Zmora O, Luglio G, et al. ECCO-ESCP consensus on surgery for Crohn’s disease. J Crohn's Colitis. 2018;12(1):1-6. doi: 10.1093/ecco-jcc/jjx061. DOI: https://doi.org/10.1093/ecco-jcc/jjx061

التنزيلات
منشور
كيفية الاقتباس
إصدار
القسم
الرخصة
الحقوق الفكرية (c) 2025 Al-Rafidain Journal of Medical Sciences

هذا العمل مرخص بموجب Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Published by Al-Rafidain University College. This is an open access journal issued under the CC BY-NC-SA 4.0 license (https://creativecommons.org/licenses/by-nc-sa/4.0/).