MANAGEMENT OF INFLAMMATORY APPENDICEAL MASS IN ZEWDITU MEMORIAL HOSPITAL, ADDIS ABABA, ETHIOPIA

Appendiceal mass is one of the complications of acute appendicitis. The management of patients with appendiceal mass is controversial and different treatment options have been suggested.

The objective of this study was to assess the results of conservative management of patients with appendiceal mass followed by interval appendicecomy.

The study was a retrospective analysis of 73 medical records of patients with appendiceal mass who were managed conservatively between March 2007 and February 2014.

Fifty patients were males and 23 patients were females making the male to female ratio of 2.2:1. The mean age was 29.6 ± 6.3 years (range 12-68 years). The maximum incidence was in the 3rd decade. Forty one (55.8%) of the patients presented one week or more after the onset of their illness. Abdominal pain, right lower quadrant (RLQ) direct and rebound tenderness were observed in all patients. Mass was detected in the RLQ in 84.9% of the patients. Sixty five patients (89%) responded to conservative treatment and these patients were discharged after a mean hospital stay of 6.5 1.5 days (range 3-12 days). Interval appendicectomy was done for 58 patients 8-16 weeks after successful conservative management. The mean hospital stay after interval appendicectomy was 3.5 ± 0.5 days with a range of 2-5 days. One patient (1.7%) had a wound infection. There were no deaths.

Initial non-operative management of appendiceal mass was successful in most cases and the complication rate after interval appendicecomy seems lower than with early operative treatment.