Routine or Selective Interval Appendectomy for Non-Surgically Treated Appendiceal Mass

ObjectivesThe purpose of this study was to evaluate the need for interval appendectomy after a successful conservative treatment of an appendiceal mass.MethodsThis retrospective study was conducted on patients admitted with appendiceal mass at King Saud Medical City during between July-2004 to July-2009. Only patients who were successfully treated conservatively (non-surgical) were included in the study. Data on patient demography, clinical presentations, investigations, follow up, relapse of symptoms and/ or recurrent acute appendicitis were collected and analyzed.ResultsSeventy-three patients were successfully treated conservatively for appendiceal mass. After discharge from the hospital, all were followed up in an OPD clinic. Seven patients (9.6%) developed recurrent symptoms/ appendicitis and underwent appendectomy. Sixty six patients (90.4%) were discharged from the outpatient clinic as they remained asymptomatic. All were seen in OPD at least twice before discharge. At the time of data collection for this study, all of them were contacted and recalled for assessment in the outpatient department. Five patients (6.8 %) had emergency appendectomy elsewhere after discharge from the OPD clinic. Overall, 12 patients (16.4 %) needed appendectomy after a successful conservative treatment for appendiceal mass. Sixty one patients (83.6 %) have remained asymptomatic since their discharge from the clinic.ConclusionRoutine interval appendectomy is unnecessary after a successful conservative treatment of an appendiceal mass. It should be recommended selectively to those who develop recurrent symptom or recurrent acute appendicitis.