Elective appendectomy: clinical case and literature review
DOI:
https://doi.org/10.31837/cir.urug/7.1.9Keywords:
Appendectomy, acute appendicitis, surgical treatmentAbstract
Introduction: inflammatory masses of appendiceal origin are infrequent, represent 3% of acute appendicitis. Its therapeutic management can be systematized in initial surgery or conservative treatment. the latter consists of exclusive antibiotic therapy, or associated with percutaneous drainage. it is an alternative to undertaking a demanding appendectomy, with the risk of not identifying the cecal appendix, visceral injury, and the need for conversion or extended resections. However, the absence of pathological diagnostic confirmation requires protocolized follow-up in order to rule out differential diagnoses of greater prognostic relevance. Objective: present the case of a patient who underwent conservative management and elective appendectomy. a bibliographic review was carried out in the databases: pubmed, cochrane library, scielo and lilacs. Discussion and conclusions: inflammatory masses of appendiceal origin represent a diagnostic and therapeutic challenge, requiring specific management and follow-up. The indication for elective appendectomy is controversial, it is considered in the presence of persistent pathological images and diagnostic doubts, or in patients with recurrent appendicitis
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Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020;15(27):1–42.
Wagner M, Tubre DJ, Asensio JA. Evolution and Current Trends in the Management of Acute Appendicitis. Surg Clin North Am. 2018;98(5):1005-1023. doi: 10.1016/j.suc.2018.05.006.
Andersson RE, Petzold MG. Nonsurgical Treatment of Appendiceal Abscess or Phlegmon: A Systematic Review and Meta-Analysis. Ann Surg. 2007;246(5):741–8. doi: 10.1097/SLA.0b013e31811f3f9f
Deelder JD, Richir MC, Schoorl T, Schreurs WH. How to Treat an Appendiceal Inflammatory Mass: Operatively or Nonoperatively? J Gastrointest Surg. 2014;18:641–5. doi: 10.1007/s11605-014-2460-1
Tekin A, Kurtoglu HC, Can I, Oztan S. Routine interval appendectomy is unnecessary after conservative treatment of appendiceal mass. Colorectal Dis. 2008;10(5):465–8.
Bailey H. The Oschner-Sherren (delayed) treatment of acute appendicitis: indications and technique. Br Med J. 1930; 1(3603):140-3. doi: 10.1136/bmj.1.3603.140
Demetrashvili Z, Kenchadze G, Pipia I, Khutsishvili K, Loladze D, Ekaladze E, et al. Comparison of treatment methods of appendiceal mass and abscess: A prospective Cohort Study. Ann Med Surg. 2019;48:48–52. doi: 10.1016/j.amsu.2019.10.016
Rao PM, Rhea JT, Novelline RA, Mostafavi AA, McCabe CJ. Effect of computed tomography of the appendix on treatment of patients and use of hospital resources. N Engl J Med. 1998;338(3):141–6. doi: 10.1056/NEJM199801153380301
Jeffery RB, Federle MP, Tolentino CS. Periappendiceal Inflammaroy Masses: CT directed management and clinical outcome in 70 patients. Radiology. 1988;167(1):13–6. doi: 10.1148/radiology.167.1.3347712
Hernandez MC, Aho JM, Habermann EB, Choudhry AJ, Morris DS, Zielinski MD. Increased anatomic severity predicts outcomes: Validation of the American Association for the Surgery of Trauma's Emergency General Surgery score in appendicitis. J Trauma Acute Care Surg . 2017;82(1):73-79. doi: 10.1097/TA.0000000000001274.
Deakin DE, Ahmed I. Interval appendicectomy after resolution of adult inflammatory appendix mass - it is necessary? Surgeon. 2007;5(1):45–50. doi: 10.1016/s1479-666x(07)80111-9
Mentula P, Sammalkorpi H, Leppaniemi A. Laparoscopic Surgery or Conservative Treatment for Appendiceal Abscess in Adults?? A Randomized Controlled Trial. Ann Surg. 2015;262(2):237–42. doi: 10.1097/SLA.0000000000001200
Fugazzola P, Ceresoli M, Agnoletti V, Agresta F, Amato B, Carcoforo P, et al. The SIFIPAC/ WSES/SICG/ SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly. World J Emerg Surg. 2020;15(19):1–15. doi: 10.1186/s13017-020-00298-0
Frias-Gonzales V, Castillo-Angeles M, Rodríguez-Castro M, Borda-Luque G. Manejo de la Masa Apendicular Inflamatoria en el Paciente Adulto en el Hospital Nacional Cayetano Heredia. Rev Gastroenterol Perú. 2012;32(3):267–72. doi: 10.47892/rgp.2012.323.290
Dixon MR, Haukoos JS, Park IU, Oliak D, Kumar RR, Arnell TD, et. Al. An assessment of the severity of recurrent appendicitis. Am J Surg. 2003;186(6):718–22. doi: 10.1016/j.amjsurg.2003.08.016.
De Jonge J, Bolmers MDM, Musters GD, Van Rossem CC, Bemelman WA, Van Geloven AAW. Predictors for interval appendectomy in non-operatively treated complicated appendicitis. Int J Colorectal Dis. 2019;34(7):1325–32. doi: 10.1007/s00384-019-03303-4
Young KA, Neuhaus NM, Fluck M, Blans JA, Hunsinger MA, Shabahang MM, et al. Outcomes of complicated appendicitis?: Is conservative management as smooth as it seems?. Am J Surg . 2018;215(4):586-592. doi: 10.1016/j.amjsurg.2017.10.032
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