Laparoscopic management of appendicular lump

Abstract

The surgical management of an appendicular lump remains controversial. With the revolution and advancement of laparoscopic instrumentation and technical learning curve, it is possible to remove an inflamed appendix in presence of lump. This retrospective study was performed between August 2018 and August 2019 in AIIMS Raipur, 86 patients were treated for appendicitis laparoscopically, in these 14 patients had appendicular lump at the time of admission. 12 patients (total 14; 2 patients were excluded) underwent laparoscopic intervention for appendicular lump. Average operative time were 90 minutes. Average post-operative hospital stay were 5 days. Post-operative complications were seen in 2 patients (surgical site infection). In histopathology report, appendicular inflammation suggestive of appendicitis were present in all operated cases. We conclude, early laparoscopic appendectomy confirms the diagnosis. It is safe and feasible in patients with appendicular lump. It reduces the treatment cost, early recovery and satisfactory overall outcome.

Early surgery for appendicular lump in pediatric patients is still safe.

“…7 Around 2-4% cases of acute appendicitis result in formation of appendicular lump. 8 In adult patients with acute appendicitis, the appendicular lump is well formed but in case of pediatric patients this doesn't happen, due to the fact that their greater omentum is not fully developed and does not give much assistance in walling off and limiting the spread of infection. 9 The traditional treatment of appendicular lump which is mostly been followed in Pakistan is conservative management.…”