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Old 07-06-2011
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Surgery Management of appendicitis?

What is the management of appendix cases?

1) perforation of appendix
2) forming mass or abscess
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Old 07-06-2011
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1) OR
2) manage with Ab+fluid+bowel rest + percutaneous aspiration in abscess followed by delayed apendectomy 6-8 weeks later
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Old 07-06-2011
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Quote:
Originally Posted by kemoo View Post
What is the management of appendix cases?

1) perforation of appendix
2) forming mass or abscess


1)appendectomy
2)conservative
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Old 07-06-2011
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Quote:
Originally Posted by confident View Post
1)appendectomy
2)conservative
ok i totally agree with Confident here ,
1. OR

2. a mass means that the infection has been walled off , contained , so no need to resect , treat conservatively , OCHSNER-SHERREN CONSERVATIVE REGIMEN.
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Old 07-06-2011
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Using the initial nonoperative approach outlined above, more than 80 percent of patients who present with a "walled-off" appendiceal process can be spared an appendectomy at the time of initial presentation. However, most will need to return for interval appendectomy Interval appendectomy has traditionally been recommended at six to eight weeks after presentation for two main reasons.

  • To prevent recurrence of appendicitis
  • To exclude neoplasms (such as carcinoid, adenocarcinoma, mucinous cystadenoma, and cystadenocarcinomas) Older patients should have a colonoscopy or barium enema to rule out cecal pathology.
For these reasons, our practice is to recommend interval appendectomy for most adult patients. Colonoscopy should be considered prior to appendectomy in patients over 50 who have not had a recent colonoscopy. Antibiotic treatment may be a useful temporizing measure, however, in environments with no surgical capabilities, such as in space flight and submarine travel.
This approach is supported by a meta-analysis of 61 observational studies in which an appendiceal abscess or phlegmon was present in 3.8 percent of patients with appendicitis . Immediate surgery was associated with higher morbidity than nonsurgical treatment. After successful nonsurgical treatment, a malignant disease was detected in 1.2 percent of cases and an important benign disease in 0.7 percent. Recurrent appendicitis developed in 7.4 percent of cases (95% CI 3.7-11.1)
Reference: uptodate

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