Farooq Ahmed, Ravindra G. Devani, Mohammed Moinuddin, Mohd. Ashfaq Ahmed
BACKGROUND Acute appendicitis is the commonest cause of acute surgical abdomen. Lump is found in 2-6% cases of acute appendicitis. Conventional treatment according to Ochsner-Sherren regime is conservative regime which is popularized as standard treatment of appendicular lump. Failure of conservative regime occurs in 2-4% cases. MATERIALS AND METHODS A Prospective Study was done in KBNTGH Gulbarga from August 2015- August 2016. Total of 60 patients admitted with a Diagnosis of Appendicular lump was included in our Study. An Analysis of Patients managed for appendicular lump was done. All the patients of both sexes between 5 to 80 years were included. RESULTS Total 700 patients admitted in hospital with diagnosis of acute appendicitis, out of which 60 patients were having appendicular lump, suggestive of incidence of 8.57%. Age group 21-30 years included more patients. Male to female ratio was 3:1. Pain was the presenting complaint in all the patients and presentation varied with history of pain 1 day to 6 months. Of 60 patients of appendicular lump, 10 patients had appendicular abscess and 50 patients had appendicular mass. 10 patients of appendicular abscess were treated surgically. Out of 50 appendicular mass patients, 44 were managed conservatively and discharged from hospital after planning for interval appendicectomy after 4-6 weeks, remaining 6 patients underwent immediate appendicectomy. CONCLUSION Clinical examination still remains the most important tool in the diagnosis of appendicular lump. Radiological investigations are necessary, when there is doubtful palpable mass. We treated patients with standard Ochsner-Sherren regimen and surgery was done when mass did not resolve or went in for complication. Majority of patients responded for conservative measures. So, we concluded that Ochsner-Sherren regimen is still preferred approach in treating appendicular mass.
