title: Management of appendiceal masses.
abstract: OBJECTIVE
  To evaluate the outcome of patients treated for appendiceal abscess, and managed either conservatively or surgically, and to describe the short and long-term outcome as well as incidence of interval appendicectomy in those treated conservatively.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University hospital, Sweden.
  
  
  METHODS
  Ninety-three patients with the diagnosis of appendiceal abscess, 50 treated conservatively and 43 who were operated on, with a mean age of 46 (14-93) years. Mean (range) follow-up for patients operated on was 65 (11-135) and for those treated conservatively 66 (6-136) months.
  
  
  METHODS
  Course of acute disease, recorded complications, recurrence of appendicitis and incidence of interval appendicectomy during follow-up.
  
  
  RESULTS
  The duration of pain before admission was 4 (0.5-82) days for those operated on and 7 (2-60) days for those treated conservatively. A palpable mass was more common in the conservatively managed group. Complications were common among patients who were operated on. No interval appendicectomies were done during the second half of the study period. 4 of the patients treated conservatively (8%) had an underlying tumour diagnosed at follow-up.
  
  
  CONCLUSIONS
  Operative management of patients with appendiceal masses seems to be associated with a high risk of postoperative complications and the risk of a more extensive surgical procedure. If possible, a conservative approach should be advocated. Because of inaccurate radiological imaging during the acute phase and the risk of an underlying malignancy, routine follow-up is necessary. Routine interval appendicectomy cannot be recommended.
authors.affiliation: Department of Surgery, Lund University Hospital, Lund, Sweden.
authors.forename: Bobby
authors.initials: B
authors.lastname: Tingstedt
authors.forename: Elinor
authors.initials: E
authors.lastname: Bexe-Lindskog
authors.forename: Mats
authors.initials: M
authors.lastname: Ekelund
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
mesh_terms: D000038:Abscess / Q000401:mortality / Q000628:therapy*; D001062:Appendectomy; D001065:Appendix; D002429:Cecal Diseases / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome