Abstract
Appendicitis is the most common surgical emergency in pediatric surgery. In the presence of an appendicular mass, surgical management can be difficult. We evaluate the results of appendix mass management both with immediate operation and conservative treatment over a period of 5 years. Forty children who presented with appendicular mass over a period of 5 years were reviewed. Their mean age was 7.6±2.7 years, and the mean duration of symptoms was 7.8±2.7 days. We evaluated the children in two groups: The first group included 19 children who were operated on immediately, and the second group included 21 children who were managed conservatively, followed by elective appendectomy. In the first group, mean hospitalization time was 8.7±3.2 days. The complication rate was found to be high (26.3%). Ileal injury occurred in two patients, intraabdominal abscess developed in one patient, and wound infection developed in another. Appendectomy could not be done in one patient who required another laparotomy 8 weeks later. In the second group, mean hospitalization time was 8.9±2.6 days. Two patients (8.6%) failed to respond to conservative management. Elective appendectomy was performed after 2–3 months. Two patients returned with perforated appendicitis 5 months and 12 months later, respectively, because they were not brought back for subsequent appendectomy. It can be concluded that conservative treatment of appendicular mass is safe; we also advocate elective appendectomy because of the probable risk of recurrence.
Similar content being viewed by others
References
Adalla SA (1996) Appendiceal mass: interval appendicectomy should not be the rule. Br J Clin Pract 50:168–169
Gahukamble DB, Gahukamble LD (2000) Surgical and pathological basis for interval appendicectomy after resolution of appendicular mass in children. J Pediatr Surg 35:424–427
Gillick J, Velayudham M, Puri P (2001) Conservative management of appendix mass in children. Br J Surg 88:1539–1542
Hoffmann J, Rolff M, Lomborg V, Franzmann M (1991) Ultraconservative management of appendiceal abscess. J R Coll Surg Edin 36:18–20
Jordan JS, Kovalcik PJ, Schwab CW (1981) Appendicitis with a palpable mass. Ann Surg 193:227–229
Nitecki S, Assalia A, Schein M (1993) Contemporary management of the appendiceal mass. Br J Surg 80:18–20
Surana R, Puri P (1995) Appendiceal mass in children. Pediatr Surg Int 10:79–81
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Erdoğan, D., Karaman, İ., Narcı, A. et al. Comparison of two methods for the management of appendicular mass in children. Ped Surgery Int 21, 81–83 (2005). https://doi.org/10.1007/s00383-004-1334-0
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-004-1334-0