IS INTERVAL APPENDECTOMY NECESSARY AFTER RUPTURE OF AN APPENDICEAL MASS

Since 1980, the authors have not routinely removed an appendix on an i nterval basis after treatment of a ruptured appendiceal mass (phlegmon and/or abscess). In the present group of patients, there were eight b oys and two girls, two to 15 years of age (mean, 8.5 years). All prese nted with symptoms and signs typical of ruptured appendix, with a mass suspected by history and examination, and proven by radiological mean s (usually ultrasonography). The patients were treated for at least 1 week with intravenous triple antibiotics; three required drainage of t heir abscess (2 radiological, 1 surgical), The follow-up has been both clinical and sonographic. In all cases the inflammation disappeared w ith 1 month. One child (2 years old) returned in 2 months with symptom s and signs of a ruptured appendix, and appendectomy was performed. Th e other nine have remained well, for 6 months to 13 years. From this e xperience and a review of the literature, only a relatively small numb er of patients with a properly treated ruptured appendiceal mass (phle gmon and/or abscess) will return with a flareup (recurrence) of append icitis (requiring appendectomy); the rest live a normal life, with the ir asymptomatic appendix intact. Copyright (C) 1996 by W.B. Saunders C ompany