Management of inflammatory appendiceal mass: a retrospective study

Abstract

The appendiceal mass is a common complication in the natural evolution of acute appendicitis, often manifested by a mass in the right quadrant, ranging from the appendiceal phlegmon to the collected abscess. Our study consist on determining the epidemiological, clinical, diagnostic and therapeutic aspects in the care of the appendiceal plastron, as well as the role of surgery in this special care. This is a retrospective study including 30 cases of appendiceal mass, excluding appendicular abscesses, collected to the general surgery department of the military hospital Avicenne of Marrakesh, over a period of 5 years,

Mucosectomy in Complicated Appendicitis

“…Surgery in such cases also avoids misdiagnosed cases and promptly deals with any unexpected ileocecal pathology that masquerades as an appendiceal mass. A more extensive incision, immaculate serosal dissection, bleeding and inadvertent gut injury are faced in these cases that lead to higher morbidity with a greater chance of paralytic ileus [7][8][9][10] . Surgery in masses is still controversial, with many surgeons advocating a conservative approach 8,9 , leading to an interval appendicectomy 11 and others in favor of surgery to prevent recurrence of symptoms, complications, or the need for return for interval appendicectomy for which most cases are lost to follow up [12][13][14][15] .…”

“…Operation in cases of appendicular masses is harder to perform. The adhesions seen in such cases require extension of the incision, difficult serosal dissection, and mobilization of the caecum which leads to delayed discharge, higher morbidity, pain, and ileus 7,8 . Removal of the appendix using the 'mucosectomy' technique developed in our Surgical unit that is carried out by avulsion and removal of the appendix out of its serosa leaving it behind decreases gut handling, chances of gut injury and lesser bleeding.…”

Características epidemiológico-clínicas y resultados del manejo del plastrón apendicular en pacientes adultos. Hospital de Emergencias José Casimiro Ulloa, 2020-2021

“…En otro estudio se halló que una de las características clínicas halladas en los pacientes con plastrón apendicular fue la presencia de dolor abdominal (100%) y el signo más encontrado fue el de una masa palpable en la fosa iliaca derecha (57,1 %) (24). Hallazgos de laboratorio: En el estudio realizado por Fassi M et al (18)., se reportó que uno de los aspectos clínicos de los pacientes con plastrón apendicular fue la PCR>5 mg/l en el 93,3% de los casos. Asimismo, en el estudio mencionado anteriormente, se halló que los pacientes con plastrón apendicular tenían leucocitosis, en el 83,3% de los casos (18).…”

“…Hallazgos de laboratorio: En el estudio realizado por Fassi M et al (18)., se reportó que uno de los aspectos clínicos de los pacientes con plastrón apendicular fue la PCR>5 mg/l en el 93,3% de los casos. Asimismo, en el estudio mencionado anteriormente, se halló que los pacientes con plastrón apendicular tenían leucocitosis, en el 83,3% de los casos (18).…”