Conservative management of appendix mass in children

Gillick, John; Velayudham, Murugesh; Puri, Prem

doi:10.1046/j.0007-1323.2001.01912.x

Cited by 83 publications

(98 citation statements)

References 9 publications

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“…Nonetheless, several previous studies reported high success rates of 76 to 97 % and a low incidence of postoperative complications after conservative management of patients with appendicitis associated with Fig. 1 Outcomes of patients with acute pediatric perforated appendicitis with abscess abscess [3,[8][9][10][11]. In our series, the success rate of 87.5 % without postoperative complications is consistent with those of previously published reports and appendicitis recurrence occurred in two patients before interval appendectomy.…”

Section: Discussionsupporting

confidence: 91%

Effectiveness of Interval Appendectomy After Conservative Treatment of Pediatric Ruptured Appendicitis with Abscess

et al. 2014

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The management of patients with acute perforated appendicitis with abscess is controversial. The aim of the present study was to assess the outcomes of treatment in patients with this condition. We retrospectively analyzed 31 patients (16 men and 15 women with a mean age of 8.4 years) with appendicitis presenting with abscess. Patients were divided into two groups (emergency operation group and interval operation group), and clinical characteristics and outcomes of treatment were investigated. On presentation, no differences in gender, age, body weight, duration of symptoms, temperature, white blood cell count, C-reactive protein level, or maximum size of the abscess in the axial view were detected between the two groups. Fifteen patients (48.4 %) underwent emergency surgery. The remaining 16 patients (51.6 %) were initially treated conservatively with antibiotics. All 16 patients underwent planned operations after receiving conservative treatment, and two (12.5 %) of these patients underwent appendectomy before the planned operation day because of recurrent appendicitis without abscess. There were no differences in the length of hospital stay. In the emergency operation group, six (40 %) patients presented with wound infection and four (26.7 %) developed a postoperative intra-abdominal abscess. No infective complications were reported in the interval operation group. Interval appendectomy after conservative treatment of pediatric ruptured appendicitis with abscess significantly reduced postoperative infection rates.

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Section: Discussionsupporting

confidence: 91%

Effectiveness of Interval Appendectomy After Conservative Treatment of Pediatric Ruptured Appendicitis with Abscess

et al. 2014

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“…They concluded that conservative management without interval appendicectomy was the most appropriate management for appendix mass and that immediate appendicectomy should only be used when initial conservative management fails. 21,23,25,29 …”

Section: Approach C An Entirely Conservative Approach Without Intervamentioning

confidence: 99%

Management of appendiceal mass

Garba

Ahmed

2008

Ann Afr Med

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Background:The management of appendiceal mass is surrounded with controversy. Traditional management has been conservative, with interval appendicectomy performed weeks after the mass had resolved. This remains the most common approach at many centers in the world. Recently, an increasing number of studies have challenged this approach. This article reviews some of the controversial issues in the management of appendix mass, assesses current practice and suggests an appropriate approach for the management of appendix mass. Methods: A Medline, Pubmed and Cochrane database search were used to find such key words and combinations of: appendix, appendiceal, appendicular, interval, appendectomy, appendicectomy, mass, abscess, phlegmon, and appendicitis. Results were saved and managed by Reference manager 11. All articles were cross-referenced by the authors. Results: A conservative management is still a highly acceptable approach for appendix mass. This should be followed with interval appendicectomy especially in patients with persistent right iliac fossa pain. Conclusion:We recommend initially conservative approach to the management of appendiceal mass especially in our environment. Keywords: Appendiceal mass, appendix abscess, appendix phlegmon, appendicitis, interval appendicectomyRésumé Contexte: La prise en charge du plastron appendiculaire est entoure de controverses. Le traitement usuel a toujours été conservateur avec l'appendicectomie réalisée plusieurs semaines après la fonte de la masse. C'est l'attitude la plus commune dans la plupart des centres à travers le monde. Récemment, un nombre croissant d'études ont conteste cette approche. Cet article passe en revue certaines controverses dans la prise en charge du plastron appendiculaire, présente les pratiques actuelles, et suggère une approche appropriée de la prise en charge du plastron appendiculaire. Méthode: Une recherche dans les bases documentaires Medline, Pubmed et Cochrane ont été faites par la recherche et la combinaison des mots clés que sont: appendice, appendiculaire, intervalle, appendicectomie, masse, abcès, phlegmon et appendicite. Les résultats ont été sauvegardes et traites a l'aide de Référence Manager 11. Tous les articles ont été recoupes par les auteurs. Résultats: Un traitement conservateur est encore une approche très acceptable pour le plastron appendiculaire. Cela devrait être suivi à distance par une appendicectomie particulièrement chez les patients ayant une douleur persistante de la fosse iliaque droite. Conclusion: Nous recommandons initialement une approche conservatrice pour la prise en charge du plastron appendiculaire particulièrement dans notre contexte.

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“…Several layers of deposits eventually result in increase in diameter and a faecolith diameter of 1cm leads to appendicular obstruction. Faecoliths are less common in children than in adults; 7.7% versus 42% (Gillick et al, 2001). A primary neoplasm of the appendix is found in 0.5-1.0% of specimens removed for appendicitis.…”

Section: Aetiology Of Appendicitismentioning

confidence: 99%