Interval Appendectomy vs Conservative Management Alone - A Therapeutic Dilemma - A Retrospective Comparative study at Chennai Medical College Hospital and Research Centre - Irungalur, a Rural Tertiary Care Centre in South India
Journal Title: International Journal of Current Research and Review - Year 2018, Vol 10, Issue 5
Abstract
Background: Acute appendicitis is the most common cause of “acute abdomen.” In the 2 to 6 % of cases if not treated early it may develop in to an appendiceal mass. Conventionally conservative treatment followed by interval appendectomy is so far followed. Recent studies discourage the role of interval appendectomy. Hence our study is focused on the pros and cons of interval appendectomy. Methods: One hundred and fifty patients with the clinical diagnosis of appendicular mass admitted in our hospital from Jan. 2013 to Dec. 2016 - 4years are divided in to two groups I and II. The group I treated with conservative management followed by interval appendectomy. The group II was treated with conservative management alone with continued follow up. In each the age and sex incidence, rate of the recurrence, complications are studied, statically analysed and interpreted. Results: The age and sex distribution in both groups 1 and 2 showed no much deviation. . In the group I recurrence was observed in 13 (17.3%) and in group II 10 patients (13.3%) that means the rest of (83.7%) and (86.7%) does not need any surgical intervention. Major complications like adhesive obstruction (4%), incisional hernia (1.3%), enterocutaneus fistula (2.6%) and sepsis(6.6%)were observed in interval appendectomy group showing the more morbidities following interval appendectomy. Other pathologies like carcinoma caecum (1.3%), mucocele of appendix (1.3%) and chron’s disease (1.%) were also encountered. Conclusion: In our study for appendiceal mass management, conservative management with interval appendectomy showed the incidence of appreciable major complication and the incidence of recurrence is low. In conservative management alone with continued follow up the incidence of recurrence is less and the complications are not much. Hence we conclude that the conservative management with continued follow up is the management of choice.
Authors and Affiliations
Dr. S. Padma
Keywords
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- EP ID EP538933
- DOI 10.7324/IJCRR.2018.1051
- Views 117
- Downloads 0
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