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APPENDICEAL MASS: DIAGNOSTICS AND TREATMENT STRATEGY

N A Maistrenko, P N Romashchenko, M V Yagin

    Vestnik Khirurgii Imeni I. I. Grekova
    |November 14, 2018
    PubMed

    Insights

    Diagnosing appendiceal mass (AM) involves assessing disease duration, palpable infiltrates, and imaging. Treatment strategies, including laparoscopic appendectomy or conservative therapy, depend on differentiating between loose and dense AM.

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Diagnostic Imaging

    Background:

    • Appendiceal mass (AM) is a frequent complication of acute appendicitis.
    • Accurate diagnosis and treatment strategies are crucial for managing AM.

    Purpose of the Study:

    • To define diagnostic criteria for appendiceal mass (AM).
    • To establish rational treatment strategies for AM based on diagnostic findings.

    Main Methods:

    • Clinical diagnosis based on disease duration (>3 days), palpable right iliac region infiltrate, and absence of positive appendiceal signs.
    • Ultrasound to differentiate AM into loose and dense types.
    • CT scans and irrigoscopy for differential diagnosis of dense AM versus colorectal cancer.
    • Diagnostic laparoscopy for uncertain cases during dynamic monitoring.

    Main Results:

    • Clinical criteria allow for the diagnosis of dense AM.
    • Ultrasound effectively differentiates loose from dense AM.
    • Imaging modalities aid in distinguishing dense AM from malignancy.
    • Diagnostic laparoscopy assists in assessing safe separation of inflammatory infiltrate.

    Conclusions:

    • A diagnostic algorithm guides treatment decisions.
    • Laparoscopic appendectomy is indicated for loose AM.
    • Conservative therapy is the recommended approach for dense AM.

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