Is Elective Interval Appendicectomy after Successful Initial Conservative Management of Appendicular Mass Necessary?

Abstract

Background The traditional management of appendicular mass is an initial conservative treatment followed by interval appendectomy. Recently interval appendicectomy has been questioned.
Objective: The purpose of this study was to clarify the need and the role of interval appendicectomy after successful initial conservative treatment.
Method: This is a prospective study conducted in a major hospital in Basra from April 2006 to Septemper2010, included 65 patients with appendicular mass which subsequently proved postinflammmatory (phlegmonous) changes of the appendix were treated conservatively.
Results: Routine interval appendicectomy was not performed and needed after successful treatment in the majority of the patients (84.6%). Four patients (6.1%) developed abscess formation and operation
was necessary to drain the abscess. Four patients were readmitted with recurrent appendicitis after 2 months. During the 2 years follow up period another 2 patients presented with recurrent symptoms of acute appendicitis and appendectomy were arranged. The recurrence rate after successful conservative treatment was 10%.
Conclusion routine interval appendectomy after initial
successful conservative treatment is of questionable
benefit and needs further assessment.