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Chirurgia 2020 October;33(5):239-43

DOI: 10.23736/S0394-9508.19.05066-6

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Surgery versus conservative treatment for appendicular mass in adults

Jasim ALABBAD 1, 2 , Fawaz ABDUL RAHEEM 2, Saba AL-SADDAH 2, Abdulaziz AL-MOBARAK 2, Hala AL-QATTAN 2

1 Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait; 2 Department of Surgery, Mubarak Al-Kabeer Hospital, Kuwait City, Kuwait



BACKGROUND: The management of adults presenting with an appendicular mass (abscess or phlegmon) remains controversial. The aim of the study was to compare the outcomes of patients with appendicular mass who underwent immediate surgery versus those who were treated conservatively.
METHODS: A retrospective study of adult patients who were admitted with appendicitis complicated with an abscess or phlegmon between September 2011 and December 2017 at a university affiliated hospital in Kuwait. Patients were grouped according to the treatment received; immediate surgery versus conservative management.
RESULTS: There were 47 patients admitted with an appendicular mass. Sixteen (34.0%) patients underwent early surgical intervention, while 31 (64.0%) patients were treated conservatively. The mean length of stay was 6.7±4.0 days for those who underwent surgical intervention and 6.0±2.5 days for those who were treated conservatively (P=0.85). The overall complication rate was 31.3% for those who underwent surgical intervention and 12.9% for those who were treated conservatively (P=0.24).
CONCLUSIONS: It appears that the early surgical management of appendicular mass is feasible and associated with similar overall complications compared with conservative management. However, a larger prospective trial is needed to validate these results.


KEY WORDS: Appendicitis; Cellulitis; Abscess; Appendix

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