A comparative study of emergency appendectomy vs conservative management in cases of early appendicular lump in a tertiary care hospital

Jitendra Narayan Senapati; Jyoti Ranjan Pani; Abhijit Samal; Rakesh Mondal

Volume : VII, Issue : VIII, August - 2017

A comparative study of emergency appendectomy vs conservative management in cases of early appendicular lump in a tertiary care hospital

Jitendra Narayan Senapati, Jyoti Ranjan Pani, Abhijit Samal, Rakesh Mondal

Abstract :

Background Acute appendicitis is the most common acute surgical condition of the abdomen. The definitive treatment of acute appendicitis is appendectomy. If timely appendectomy is not done, 2 – 6% of the patients develop a mass in the right iliac fossa (Appendicular lump) as one of the early complications. The conventional conservative treatment followed by delayed appendectomy in patients with appendicular mass is well recommended. Majority of the times appendicular lump resolve after conservative management but some 15 – 20% of such patients fail to respond and require urgent and more difficult operation, often the patient ending up with a temporary diversion procedure. Aims and objective: a comparative study of early exploration vs conservative management of appendicular lump. Materials & Method: A total of 80 patients with appendicular lump and acute appendicitis were taken in to consideration for this study in two groups of early appendectomy and conservative management group. Results: There was not a drastic difference observed in post–operative wound sepsis in each group. Residual abscess was seen mostly in patients of group 2 however not in group 1. One patient in group 1 developed faecal fistula that was treated successfully with conservative treatment. 3 (9.67%) patients in group 2 developed intestinal obstruction due to adhesive bands. Chest related complication were more in group 2 due to prolonged hospital stay. Eight patients (25.8%) in group 2 failed to respond to conservative treatment, thereby needing readmission where intervention was done rather in a difficult emergent situation. Conclusion: With the modern day advancements in surgical science & post–operative care cases of appendicular lump should be taken up for early appendectomy keeping in view the uncertain prognosis if treated conservatively