Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy

Lasson, Åke; Lundagårds, Jan; Lorén, Ingemar; Nilsson, Patric

doi:10.1002/ejs.44

Cited by 46 publications

(31 citation statements)

References 19 publications

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“…PAA is usually managed with percutaneous drainage and antibiotics, and interval appendectomy is generally indicated [2][3][4][5]. TOA is a complication of pelvic inflammatory disease (PID), with ascending vaginal or cervical infections progressing to endometritis, salpingitis, and later, pyosalpinx.…”

Section: Introductionmentioning

confidence: 99%

CT differentiation between tubo-ovarian and appendiceal origin of right lower quadrant abscess: CT, clinical, and laboratory correlation

et al. 2015

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To investigate which clinical, laboratory, and CT findings potentially facilitate the differential diagnosis between tubo-ovarian abscess (TOA) and periappendicular abscess (PAA), we retrospectively reviewed abdominal CT examinations and medical records for all women who presented to our medical center with unilateral right pelvic abscess formation who underwent CT evaluation from 2004-2014. A wide spectrum of clinical data and imaging findings were recorded. CT diagnoses were made in consensus by two experienced body radiologists blinded to the final diagnosis. Findings associated with the infections were compared using the chi-square (χ(2)) or the Fisher exact test. Ninety-one patients were included; 58 with PAA (mean age 46 years) and 33 with TOA (mean age 37 years). Pain on cervical motion (67 %) and vaginal discharge (21 %) were significantly more common in TOA; other clinical signs were similar. The presence of right ovarian vein entering the mass on CT had 100 % specificity and 94 % sensitivity to TOA. Distended right fallopian tube (79 %), mass posterior to mesovarium (76 %), contralateral pelvic fat stranding (55 %), and thickening of sacrouterine ligaments (55 %) were significantly more common in TOA. Positive "arrowhead sign" (91 %), mesenteric lymphadenopathy (85 %), small bowel wall thickening (55 %), fluid in the right paracolic gutter (50 %), and cecal wall thickening (48 %) were significantly more common in PAA;internal gas was revealed only in PAA (33 %). Distinct CT features can increase diagnostic certainty regarding the origin of right lower quadrant abscess in women.

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Section: Introductionmentioning

confidence: 99%

CT differentiation between tubo-ovarian and appendiceal origin of right lower quadrant abscess: CT, clinical, and laboratory correlation

et al. 2015

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“…1 The management of appendiceal abscess in a systemically unwell patient is generally accepted as percutaneous drainage of the collection or open appendicectomy. 2,3 However, the management of a systemically well patient with an appendiceal phlegmon is more controversial. Management is either operative or conservative.…”

mentioning

confidence: 99%

Appendix mass: do we know how to treat it?

Ahmed¹,

Deakin²,

Parsons³

2005

Ann R Coll Surg Engl

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INTRODUCTION The traditional management of appendiceal mass has been an initial conservative approach followed by interval appendicectomy. More recently, the necessity of interval appendicectomy has been questioned by a growing amount of evidence in the surgical literature. The aim of this study was to review the available scientific evidence and to determine how appendiceal masses are currently being managed in the Mid-Trent region by general surgeons.PATIENTS & METHODS A literature search using Medline, Embase, Cinahl, HMIC and Biosis was carried out. A personal or telephonic survey of all consultants and specialist registrars working in general surgery in the Mid-Trent region (n = 67) was conducted recording their management protocol of 3 different clinical scenarios -a 14-year-old boy, a 29-year-old female and a 68-year-old male. Responses of the questionnaire were entered to a database in Microsoft Access 2000 and analysed. RESULTS The results showed that there was difference of opinion on the management of appendix mass in either scenario. Appendectomy (interval or emergency) is still practised by 75% of general surgeons in the Mid-Trent region and less that 25% manage asymptomatic appendix mass without interval appendectomy. Additionally, specialist registrars appear more likely not to offer patients interval appendicectomy after successful conservative management (P < 0.05).CONCLUSIONS At present, there is no agreed consensus on the management of appendiceal mass. There is a need to develop a protocol for the management of this common problem.

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“…10 et al said that percutaneous aspiration followed by interval appendicectomy for appendicular abscess is the best treatment. Recurrent appendicitis is common if abscess drainage done without interval appendicectomy.…”

Section: Appendicular Pathologymentioning

confidence: 99%

Evaluation of Right Iliac Fossa Mass-a Retrospective Study

Graham¹,

Vijayabhasker²

2016

jemds

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Mass in right iliac fossa is one of the common clinical surgical entity with varied etiologies, involving intra peritoneal organs like vermiform appendix, caucus, ileum, retroperitoneal structures like kidneys, blood vessels etc., and abdominal wall masses like desmoids tumor. To know the etiology and the various pattern of presentation of right iliac fossa mass in our institution a retrospective study was designed including all adult patients diagnosed to have a mass in right iliac fossa. Pediatric patients and female patients having a mass due to gynaecological diseases were excluded from this study. All clinical parameters, radiological investigations, biochemical investigations, endoscopy, cytology, biopsy were collected and analysed systematically.

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Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy

Cited by 46 publications

References 19 publications

CT differentiation between tubo-ovarian and appendiceal origin of right lower quadrant abscess: CT, clinical, and laboratory correlation

CT differentiation between tubo-ovarian and appendiceal origin of right lower quadrant abscess: CT, clinical, and laboratory correlation

Appendix mass: do we know how to treat it?

Evaluation of Right Iliac Fossa Mass-a Retrospective Study

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