Utpal De1, Shibajyoti Ghosh. 1. Department of Surgery, Bankura Sammalani Medical College and Hospital, Bankura, W. Bengal, India. utpalde@vsnl.net
Abstract
OBJECTIVE: To study the feasibility of acute appendicectomy in patients with an appendicular mass. SETTING: Department of Surgery, Bankura Sammalani Medical College (BSMCH), Bankura, West Bengal, India. PATIENTS: From January 1998 to May 2001. 87 patients were diagnosed and operated for appendix mass within 24 h of admission. None of the patients had any associated complications. INTERVENTION: A McBurney's incision with Rutherford-Morrison extension was made in most patients. RESULTS: 48 patients presented with a classical appendix mass. 25 patients (28.7%) had classical features of appendix abscess, and in 14 (16.1%) a loculated collection of pus (10 to 50 ml) was found. Operative time ranged from 45 to 90 min (mean 65). Pathologic evidence of appendicitis was present in all patients. 71 patients were discharged on the seventh postoperative day. 15 patients developed minor wound infection. One patient developed band obstruction, which subsided spontaneously on conservative treatment. Rest of the patients are doing well. CONCLUSION: Low morbidity, reduced hospital stay, low cost and patient compliance favour operative management of appendicular mass by experienced surgeons thus obviating the old practice of conservative treatment followed by interval appendicectomy.
OBJECTIVE: To study the feasibility of acute appendicectomy in patients with an appendicular mass. SETTING: Department of Surgery, Bankura Sammalani Medical College (BSMCH), Bankura, West Bengal, India. PATIENTS: From January 1998 to May 2001. 87 patients were diagnosed and operated for appendix mass within 24 h of admission. None of the patients had any associated complications. INTERVENTION: A McBurney's incision with Rutherford-Morrison extension was made in most patients. RESULTS: 48 patients presented with a classical appendix mass. 25 patients (28.7%) had classical features of appendix abscess, and in 14 (16.1%) a loculated collection of pus (10 to 50 ml) was found. Operative time ranged from 45 to 90 min (mean 65). Pathologic evidence of appendicitis was present in all patients. 71 patients were discharged on the seventh postoperative day. 15 patients developed minor wound infection. One patient developed band obstruction, which subsided spontaneously on conservative treatment. Rest of the patients are doing well. CONCLUSION: Low morbidity, reduced hospital stay, low cost and patient compliance favour operative management of appendicular mass by experienced surgeons thus obviating the old practice of conservative treatment followed by interval appendicectomy.