Published: 2021-03-26

A prospective study on appendicular mass

K. Ravichandran, R. Jayaraman, K. Nithya


Background: The immediate management of appendicular mass have always been controversial. Early appendicectomy (within 72 hours of presentation) is preferred in some cases, while in others non operative conservative management is advocated. Usually successful conservative management (Ochsner Sherren regimen) is followed by interval appendicectomy (6-8 weeks later). This study determines the outcome of different modalities of intervention in patients with appendicular mass.

Methods: A prospective study was conducted in Rajah Muthiah medical college hospital in department of general surgery from June 2018 to December 2020, in cases diagnosed to have appendicular mass. A total of 116 patients were included. After taking detailed history and clinical examination, relevant blood and radiological investigations, were done to achieve the final diagnosis. Presentation, examination findings, investigations, type of surgery, duration of surgery, post-operative complications and duration of hospital stay were studied. Data was collected, compiled, tabulated and analysed.

Results: Conservative management followed by interval appendicectomy had lesser incidence of complications like Intraoperative adhesions, surgical site infection, wound dehiscence and enterocutaneous fistula. It also had relatively lesser operative time and lesser period of hospital stay.

Conclusions: On comparing the different modalities of intervention, conservative management followed by interval appendicectomy is quite effective and safe method of treatment, with less operative difficulties and better outcome.


Appendicular mass, Interval appendicectomy, Ochsner Sherren regimen

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Abdelrahman MT, Mourgi AM, Karam AR, Alfaar SF, Alosaimi MA, Alasiri MS. A survey of management of appendiceal mass among surgeons: what is best practice? Int Surg J. 2017;4:1850-5.

Pandey PC, Kesharwani CR, Chauhan SGC. Management of Appendicular Lump: Early exploration Vs conservative management. Int J Med Sci Public Health. 2013;2:1046-9.

Irfan M, Hogan AM, Gately R, Lowery AJ, Waldron R, Khan W, et al. Management of the Acute Appendix Mass: A Survey of Surgical Practice. Ir Med J. 2012;105:303-5.

Hanif SM, Tahir HT, Sheikh AI, Ranjha ZM. Acute appendicitis: gaining time in mass casualty scenario. Pak Armed Forces J Med. 2010;3:23-5.

Nasir Meshikhes AW. Appendiceal mass: Is interval appendicectomy “something of the past”? World J Gastroenterol. 2011;17:2977-80.

Geofferey F, Steven RD, David WM, Jeffrey B M. Appendix. Shakelford`s Surgery of the alimentary tract, Elsevier. 8th Edition. 2019;164:1951-5.

Mike KL, Roland EA, Bernard MJ, David HB. Appendix. Schwartz’s Principles of Surgery. F. Charles Brunicardi, et al. McGraw-Hill Education, Tenth Ed. 2015;30:1243-50.

Gerard MD. Appendix in Current diagnosis &treatment. Surgery Gerard M Doherty, 13th Edition. 2010;28:615-20.

Olsen J, Skovda J, Qvist N, Bisgaard T. Treatment of appendiceal mass-a qualitative systematic review. Dan Med J. 2014;61:A4881.

Arshad MM, Shaikh NA. Recent Trends in the Treatment of the Appendicular Mass, Appendicitis-A Collection of Essays from Around the World, Dr. Anthony Lander (Ed). 2012;5:87 -95.

Brian WE, Simon-Paterson-Brown. In Acute appendicitis in Hamilton Baily’s emergency surgery. Published by Arnold, 13th Edn. 2000;399-410.

Lai HW, Loong CC, Chiu JH, Chau GY, Wu CW, Lui WY et al. Interval appendectomy after conservative treatment of an appendiceal mass. World J Surg. 2006;30:352-7.

Bahram MA. Evaluation of early surgical management of complicated appendicitis by appendicular mass. Int J Surg. 2011;9:101-3.

Willemsen PJ, Hoorntje LE, Eddes EH, Ploeg RJ. The need for interval appendectomy after resolution of an appendiceal mass questioned. Dig Surg. 2002;19:216-20.

Norman SW, Christopher JKB, O’ Connel PR. Vermiform appendix in Short practice of surgery. Edward Arnold publisher Ltd. 25th ed. 2008;1205-17.

Cheng Y, Zhou S, Zhou R, Lu J, Wu S, Xiong X et al. Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. Cochrane Database Syst Rev. 2015;2:20-8.

Meshikhes AW. Management of Appendiceal Mass: Controversial Issues Revisited. J Gastrointest Surg. 2008;4:767-75.

De U, Ghosh S. Acute Appendicectomy For Appendicular Mass: A Study of 87 Patients. Ceylon Med J. 2002;47:117-8.