Approach to Appendiceal Masses Due to Acute Appendicitis: Analysis of 126 Cases

Abstract

Aim:This study aimed to present our clinical approach in patients with clinical manifestations of delayed appendicitis and appendiceal mass.Method:Data of 126 patients with appendiceal mass and admitted to our clinic between January 2008 and December 2018 were retrospectively analyzed. Diagnoses were made by physical examination, laboratory examination, and imaging methods.Results:Of the 126 patients, 43 (34.1%) underwent emergency surgery. Of those emergent cases, 36 patients underwent appendectomy and seven had right hemicolectomy. The pathological finding was adenocarcinoma in three patients (2.4%) who underwent right hemicolectomy. Twenty-nine patients (23%) underwent interval appendectomy. The mean duration of interval appendectomy was 6.2 (range, 2-10) months. The pathological finding was appendicitis in all patients. The mean follow-up period of the 54 patients (42.9%) who did not undergo surgery was 32.6±2.4 months. During this follow-up period, three patients were diagnosed with appendix tumours and two patients with Crohn’s disease. Appendectomy was performed in two (1.3%) patients.Conclusion:Appendiceal masses may be treated conservatively without delayed appendectomy. Patients can undergo surgery only in case of recurrence of appendicitis. Computed tomography and colonoscopy within 4-6 weeks after completing the conservative treatment is recommended in all patients. However, this treatment protocol should be supported by larger prospective studies with long-term follow-up.

Keywords

• appendiceal mass
• emergency appendectomy
• interval appendectomy
• appendicitis