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Management of Appendicitis Presenting with Abscess or Mass

PURPOSE: Management strategy in acute appendicitis patients initially presenting with abscess or mass is surrounded with controversy. This study was performed to identify the outcomes of management for this condition. METHODS: We retrospectively analyzed prospectively registered 76 patients (male:fe...

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Autores principales: Kim, Jeong-Ki, Ryoo, Seungbum, Oh, Heung-Kwon, Kim, Ji Sun, Shin, Rumi, Choe, Eun Kyung, Jeong, Seung-Yong, Park, Kyu Joo
Formato: Texto
Lenguaje:English
Publicado: The Korean Society of Coloproctology 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017977/
https://www.ncbi.nlm.nih.gov/pubmed/21221242
http://dx.doi.org/10.3393/jksc.2010.26.6.413
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author Kim, Jeong-Ki
Ryoo, Seungbum
Oh, Heung-Kwon
Kim, Ji Sun
Shin, Rumi
Choe, Eun Kyung
Jeong, Seung-Yong
Park, Kyu Joo
author_facet Kim, Jeong-Ki
Ryoo, Seungbum
Oh, Heung-Kwon
Kim, Ji Sun
Shin, Rumi
Choe, Eun Kyung
Jeong, Seung-Yong
Park, Kyu Joo
author_sort Kim, Jeong-Ki
collection PubMed
description PURPOSE: Management strategy in acute appendicitis patients initially presenting with abscess or mass is surrounded with controversy. This study was performed to identify the outcomes of management for this condition. METHODS: We retrospectively analyzed prospectively registered 76 patients (male:female = 39:37; mean age, 50.8 years) with appendicitis presenting with abscess or mass over a 9-year period at the Seoul National University Hospital. Patients were divided into three groups (emergency operation group, delayed operation group, and follow-up group), and clinical characteristics and outcomes of treatment were investigated. RESULTS: Twenty-eight patients (36.8%) underwent an emergency operation. Of the remaining 48 patients, 20 (41.7%) were initially treated with conservative management through the use of antibiotics only; the other 28 (58.3%) with and additional ultrasound-guided percutaneous drainage of the abscess. Twenty-six (54.2%) patients underwent planned operations after conservative management, and 22 (45.8%) were followed without surgery (median duration, 37.8 month), of which 3 (13%) underwent an appendectomy due to recurrent appendicitis (mean of 56.7 days after initial attack). There were no statistical differences in types of operation performed (appendectomy or ileocecectomy), postoperative complications, and postoperative hospital stay among the patients who underwent emergency operations, delayed operations and operations for recurrence during follow-up. CONCLUSION: Although the recurrence rate was relatively low after conservative management for appendicitis patients presenting with abscess or mass, there was no difference in surgical outcome between the emergent, elective, or recurrent groups. Our results indicate that proper management of appendicitis with abscess or mass can be selected according to surgeon's preference.
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spelling pubmed-30179772011-01-10 Management of Appendicitis Presenting with Abscess or Mass Kim, Jeong-Ki Ryoo, Seungbum Oh, Heung-Kwon Kim, Ji Sun Shin, Rumi Choe, Eun Kyung Jeong, Seung-Yong Park, Kyu Joo J Korean Soc Coloproctology Original Article PURPOSE: Management strategy in acute appendicitis patients initially presenting with abscess or mass is surrounded with controversy. This study was performed to identify the outcomes of management for this condition. METHODS: We retrospectively analyzed prospectively registered 76 patients (male:female = 39:37; mean age, 50.8 years) with appendicitis presenting with abscess or mass over a 9-year period at the Seoul National University Hospital. Patients were divided into three groups (emergency operation group, delayed operation group, and follow-up group), and clinical characteristics and outcomes of treatment were investigated. RESULTS: Twenty-eight patients (36.8%) underwent an emergency operation. Of the remaining 48 patients, 20 (41.7%) were initially treated with conservative management through the use of antibiotics only; the other 28 (58.3%) with and additional ultrasound-guided percutaneous drainage of the abscess. Twenty-six (54.2%) patients underwent planned operations after conservative management, and 22 (45.8%) were followed without surgery (median duration, 37.8 month), of which 3 (13%) underwent an appendectomy due to recurrent appendicitis (mean of 56.7 days after initial attack). There were no statistical differences in types of operation performed (appendectomy or ileocecectomy), postoperative complications, and postoperative hospital stay among the patients who underwent emergency operations, delayed operations and operations for recurrence during follow-up. CONCLUSION: Although the recurrence rate was relatively low after conservative management for appendicitis patients presenting with abscess or mass, there was no difference in surgical outcome between the emergent, elective, or recurrent groups. Our results indicate that proper management of appendicitis with abscess or mass can be selected according to surgeon's preference. The Korean Society of Coloproctology 2010-12 2010-12-31 /pmc/articles/PMC3017977/ /pubmed/21221242 http://dx.doi.org/10.3393/jksc.2010.26.6.413 Text en © 2010 The Korean Society of Coloproctology http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Jeong-Ki
Ryoo, Seungbum
Oh, Heung-Kwon
Kim, Ji Sun
Shin, Rumi
Choe, Eun Kyung
Jeong, Seung-Yong
Park, Kyu Joo
Management of Appendicitis Presenting with Abscess or Mass
title Management of Appendicitis Presenting with Abscess or Mass
title_full Management of Appendicitis Presenting with Abscess or Mass
title_fullStr Management of Appendicitis Presenting with Abscess or Mass
title_full_unstemmed Management of Appendicitis Presenting with Abscess or Mass
title_short Management of Appendicitis Presenting with Abscess or Mass
title_sort management of appendicitis presenting with abscess or mass
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017977/
https://www.ncbi.nlm.nih.gov/pubmed/21221242
http://dx.doi.org/10.3393/jksc.2010.26.6.413
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