The management of appendiceal mass in children: Is interval appendectomy necessary?

In this study we aimed to show that performing interval appendectomy is unn ecessary in the management of appendiceal mass in children. Between 1990 an d 1996, 866 patients were treated for appendicitis. Abdominal ultrasonograp hy (USG) was performed in patients who were admitted with abdominal pain, v omiting, and fever accompanying a mass in the right lower quadrant. Sevente en patients (12 boys and 5 girls, with a mean age of 9.5 years) with a mass in the appendiceal lodge and no abscess formation were treated conservativ ely. Appendectomy was performed on any patients with perforated or unperfor ated appendicitis who had an appendiceal abscess with a mass in the right i liac fossa. Three-agent antibiotic therapy was administered for at least 1 week. These patients were discharged after a mean hospital time of 9.7 days if regression of the mass was seen ultrasonographically. They were followe d up for 1-60 months by physical examination and USG, and 11 of the 17 also underwent barium enema. USG demonstrated disappearance of the mass and bar ium enema showed a normal appendix in 10 of the 11 patients. No recurrent a ppendicitis was detected during follow-up for 1-7 years. This study shows t hat appendiceal masses that are perforated, ut localized with no fluid cont ent revealed by USG, can be treated conservatively even if they are detecte d late.