Comparative Study of Non-operative versus Operative Management of Appendicular Lump – A Retrospective Study
Background: Acute appendicitis is one of the most common acute surgical conditions of the abdomen and appendicular lump
is formed if treatment is delayed. There is no clear standardized approach to complicated appendicitis associated with abscess
or phlegmon. Hence, different therapy would be useful and cost effective.
Materials and Methods: Out of 60 patients classified into Group I – Emergency surgery group 19 (5/61) and Group II conservative
treatment – 41. (a) Surgery after certain time (II A). (b) Ambulatory follow-up (II B). (c) Underwent appendectomy (II C).
Results: Clinical manifestations of Group-I and Group-II were compared. Duration of symptoms was 6.68 in Group I and 9.58 in
Group-II. Body temperate in Group-I 38.1°C, Group-II 36.76°C Heart rate (pulse/min) 87.48 in Group-I, 85.73 in Group-II, WBC
count – 13.252 in Group-I, 132010 in Group-II size of abscess (cm) 4.40 in Group-I, 4.98 in Group-II. In surgical appendectomy 14
patients were in Group-I, 26 patients were in Group-II, ileostomy 04 were in Group-I ,3 were in Group-II, in right hemicolectomy
only 2 in Group-II, operation time 106.68 (min) in Group-I, 88.19 in Group-II post-operative complication 2 in Group-I, 5 in GroupII, post-operative hospital stay 9.48 in Group-II, 9.3 in Group-I.
Conclusion: Non-operative management of complicated appendicitis has more failure rates, increased hospital expenses,
and perhaps increased morbidity when compared to immediate surgical management of complicated appendicitis remains gold
standard and should be used in most patients.
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