Abstract
The objective of this work was to conduct a truly rural-based study to evaluate, from our own rural data devoid of influence from urban-based studies, the management of appendiceal masses in a typical peripheral hospital in Nigeria. The study aimed to highlight the results of neglected appendicitis in our community and the occasional difficulty of making a correct preoperative diagnosis. It also sought to draw the attention of the health care practitioner in our community to the importance of continued enlightenment of the people regarding the need to seek medical treatment early. This was a retrospective study, with the setting at St. Victoria Specialist Hospital, Ekwulobia, Anambra State, Nigeria, a rural hospital serving its community. A series of 30 patients who were managed for an appendiceal mass between January 1, 1992 and December 31, 2001, a 10-year period, were included in the study. We identified the cases by reviewing the surgical register. The relevant case notes were retrieved from the Records Department. The following data were extracted for each patient: age and sex; how early the patient presented; the history and presentation of the patient; whether the diagnosis was made before or during surgery; the treatment modality; length of hospital stay; and outcome. The results showed that 13 patients (43.3%) presented more than 1 week after the onset of symptoms. The age range was 15 to 60 years (average 27 years); 13 patients (43.3%) were in the age range of 40–49 years. Twenty men and ten women were treated, giving a male/female ratio of 2:1. The main clinical features were fever, anorexia, pain, tenderness, and a palpable mass in the right iliac fossa. The problem was diagnosed before surgery in 23 patients (76.7%) and during surgery in 7 (23.3%). Treatment modalities were conservative + interval appendectomy in 18 patients (60%); open and close + conservative + interval appendectomy in 3 patients (10%); immediate appendectomy without burying the stump in 2 cases (6.7%); right hemicolectomy (in one 40-year-old woman and one 55-year-old man); and incision and drainage of an appendiceal abscess in 5 patients (16.7%). No deaths were recorded. The study showed that appendical masses are most prevalent during the fifth decade of life and are rare before age 10 and after age 60. More men are affected than women, and most cases can be diagnosed before surgery, although some patients must await more sophisticated diagnostic tools or surgical exploration for diagnosis.
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References
K Kafetz (1999) ArticleTitleAppendix abscess: a surgical giant presenting as a geriatric giant Age Ageing 28 319–320 Occurrence Handle10.1093/ageing/28.3.319 Occurrence Handle1:STN:280:DyaK1MzhsVyksA%3D%3D Occurrence Handle10475872
WS Willmore AG Hill (2001) ArticleTitleAcute appendicitis in a Kenyan rural hospital East Afr. Med. J. 78 355–357 Occurrence Handle1:STN:280:DC%2BD383itFKjsw%3D%3D Occurrence Handle11957258
Y Harouna S Amadou M Gazi et al. (2000) ArticleTitleAppendicitis in Niger: current prognosis Bull. Soc. Pathol. Exot. 93 314–316
RT Poon KW Chu (1999) ArticleTitleInflammatory caecal masses in patients presenting with appendicitis World J. Surg. 23 713–726 Occurrence Handle1:STN:280:DyaK1Mzit1agtQ%3D%3D Occurrence Handle10390592
P Schmidt JL Koltai A Weltzien (1999) ArticleTitleActinomycosis of the appendix in childhood Pediatr. Surg. Int. 15 63–65 Occurrence Handle10.1007/s003830050515 Occurrence Handle1:STN:280:DyaK1M7hsF2ntA%3D%3D Occurrence Handle9914360
JM Gronroos P Gronroos (1999) ArticleTitleLeucocyte count and C-reactive protein in the diagnosis of acute appendicitis Br. J. Surg. 86 501–504 Occurrence Handle10.1046/j.1365-2168.1999.01063.x Occurrence Handle1:STN:280:DyaK1M3jtlOluw%3D%3D Occurrence Handle10215824
SH Kim HK Lim WJ Lee et al. (1998) ArticleTitleMucocoele of the appendix: ultrasonographic and CT findings Abdom. Imaging 23 292–296 Occurrence Handle10.1007/s002619900343 Occurrence Handle1:STN:280:DyaK1c3jslKrsQ%3D%3D Occurrence Handle9569300
RH Lo PS Kan (1998) ArticleTitleAppendiceal mucinous cystadenoma presenting as “porcelain” appendix with myxoglobulosis: a rare cause of right lower quadrant mass Singapore Med. J. 39 174–176 Occurrence Handle1:STN:280:DyaK1czktVyjsw%3D%3D Occurrence Handle9676150
S Eriksson J Styrud (1998) ArticleTitleInterval appendicectomy: a retrospective study Eur. J. Surg. 164 771–775 Occurrence Handle10.1080/110241598750005417 Occurrence Handle1:STN:280:DyaK1M%2FlsVSnsA%3D%3D Occurrence Handle9840307
M Alaminos-Mingorance J Castejon-Casado JC Valladares-Mendias et al. (1998) ArticleTitleDeferred appendectomy in a case of appendiceal mass Cir. Pediatr. 11 168–177 Occurrence Handle1:STN:280:DyaK1M7is1Ohuw%3D%3D Occurrence Handle9927768
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Okafor, P., Orakwe, J. & Chianakwana, G. Management of Appendiceal Masses in a Peripheral Hospital in Nigeria: Review of Thirty Cases. World J. Surg. 27, 800–803 (2003). https://doi.org/10.1007/s00268-003-6891-1
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DOI: https://doi.org/10.1007/s00268-003-6891-1