Abstract
Background. Interval appendectomy (IA) is classically performed after successful non-operative treatment of inflammatory non-complicated appendix mass (AM); although this strategy is well accepted it has recently been questioned. The purpose of this study was to evaluate the efficacy of conservative treatment, the true risk factors for recurrent appendicitis and accordingly the necessity for IA after successful conservative treatment of an AM.
Patients and Methods. This is a prospective observational study included 62 patients suffering from AM admitted to Sohag University Hospital between August 2013& July 2014. Patients were allocated into two groups; group (A) included 46 patients with successful conservative management and group (B) included 16 patients with recurrent appendicitis after successful conservative management with subsequent IA. Patients were evaluated regarding demographic criteria, clinical picture, different investigations, efficacy of conservative management and different risk factors for recurrent appendicitis were analyzed after a mean follow-up of 2 years.
Results. Conservative management had a very high success rate (88%). Recurrent appendicitis developed in (26%) of patients, (69%) of these recurrences occurred in the first 6 months of follow-up. 75% of recurrent appendicitis patients had appendicolith which proved to be a specific risk factor by both Univariate and Multivariate analysis in addition to female sex and past history of appendicitis, all proved to be independent risk factor.
Conclusion. Although conservative treatment after inflammatory non-complicated AM is justified without subsequent IA, it is better to do IA routinely for such patients as we cannot predict which patients will develop recurrent appendicitis in the future.