Operation with appendectomy for appendiceal mass carries a high risk of complications compared with conservative treatment or drainage .
Drainage may lower the risk of treatment failure but entails a risk of complications .
INTRODUCTION The treatment strategy for appendiceal mass is controversial , ranging from operation or image-guided drainage to conservative treatment with or without antibiotics .
The aim of this study was to assess the various treatment modalities with respect to complications and treatment failure .
Appendiceal mass: conservative therapy followed by interval laparoscopic appendectomy.
BACKGROUND Current therapy of patients with appendiceal abscess or phlegmon is in evolution . Controversial areas include initial conservative therapy , drainage of periappendiceal abscesses , and the role of interval appendectomy . OBJECTIVE To evaluate the safety and efficacy of conservative therapy and of interval laparoscopic appendectomy ( ILA ) . PATIENTS AND METHODS Patients with signs and symptoms of acute appendicitis and a palpable right lower quadrant mass were included . Abscess/phlegmon was documented with ultrasound or computerized tomography . After initial therapy with antibiotics , patients were discharged to home . ILA was performed 6 to 12 weeks later . RESULTS Twelve patients were included . Four patients had phlegmonous appendicitis and eight had an abscess , but only four had percutaneous drainage . All patients improved without surgical exploration and were subjected to ILA . ILA was successful in 11 of 12 patients ; a median hospital postoperative stay of 1 day was required , and no perioperative morbidity was encountered . All patients returned to routine activities within 2 weeks of surgery . CONCLUSIONS 1 ) Initial conservative management of patients with appendiceal abscess/phlegmon is prudent , safe , and effective . 2 ) Interval laparoscopic appendectomy can be performed safely and effectively
Operation with appendectomy for appendiceal mass carries a high risk of complications compared with conservative treatment or drainage .
Drainage may lower the risk of treatment failure but entails a risk of complications .
INTRODUCTION The treatment strategy for appendiceal mass is controversial , ranging from operation or image-guided drainage to conservative treatment with or without antibiotics .
The aim of this study was to assess the various treatment modalities with respect to complications and treatment failure .