Appendicular Mass at El Obeid Hospital, Western Sudan
الملخص
Background: Acute appendicitis is a common disease but some patients were only diagnosed after they develop serious complications like appendicular mass.
Objectives: The objective was to study the clinical presentations, treatment and outcomes of patients with appendicular mass seen at El Obeid Hospital, Western Sudan.
Materials and Methods: In a prospective study the information about all patients with appendicular mass who were admitted to the wards of the University Surgical Unit at El Obeid Teaching Hospital, Western Sudan during the year 2012 were collected in a pre-designed questionnaire. The data were analyzed using SPSS PC packages version 17.5.
Results: There were one hundred and three patients; 58 males and 45 females. The mean age was 29.5 years ± S.D. 17.8. Most of the patients (76%) came from rural areas. The delay in time of presentation varied from 3 days to two weeks, but the majority (93%) visited a clinical setting where misdiagnosed or mismanaged. 85% of the patients had appendicectomy (emergency or elective), 10% had drainage of appendicular abscess and 2% underwent right hemi-colectomy. 3% of the patients failed to re-appear for elective operation. Post-operative complications were fever (4.8%), wound infection (5.8%), paralytic ileus (1.9%) and faecal fistula (0.9%). There was no mortality among this series.
Conclusions: Most of the patients with appendicular mass were misdiagnosed or mismanaged before being admitted to the surgical wards. Awareness of the health providers in this community about acute appendicitis, its complications and its management needs to be revised
المراجع
2. Nitecki S, Assalia A, Schein M. Contemporary management of the appendiceal mass. Br J Surg. 1993; 80: 18-20.
3. Doumi EA, Abdelrahman IH. Acute Appendicitis: Still a Missed Diagnosis in El Obeid, Western Sudan. Sudan JMS. 2007; 2(1): 7- 8.
4. Abel Razig M, El Tayeb S, Ibnouf MAM. 7Appendicular Mass Revisited.Sudan JMS. 2007; 2(1): 33-35.
5. Bailey H.The Ochsner-Sherren (Delayed) Treatment of Acute Appendicitis: Indications and Technique.BMJ. 1930; 140-143.
6. Awad A, Eltayeb I, Matowe L, et al. Selfmedication with Antibiotics and Antimalarials in the community of Khartoum State, Sudan. J Pharm Pharmaceut Sci. 2005; 8(2): 326-331.
7. Elsiiddi HA. Irrational use of antibiotics among people residing in Almamoura. Sudanese Journal of Public Health. 2010; 5(1): 50-53.
8. Okafor PI, Orakwe JC, Chianakwana GU. Management of appendiceal masses in a peripheral hospital in Nigeria: review of thirty cases. World J Surg. 2003. 27(7): 800 - 803.
9. Willemsen PJ, Hoorntje LE, Eddes EH, Ploeg RJ. The need for interval appendectomy after resolution of an appendiceal mass questioned. Dig Surg. 2002; 19(3): 216-220.
10. Tekin A, Kurtoğlu HC, Can I, Oztan S. Routine interval appendectomy is unnecessary after conservative treatment of appendiceal mass. Colorectal Dis. 2008. 10(5): 465- 468.
11. Arshad M, Aziz LA, Qasim M, Talpur KA. Early appendicectomy in appendicular mass - a Liaquat Hospital experience. J Ayub Med Coll Abbottabad. 2008; 20(1): 70-72.
12. Lai HW, Loong CC, Chiu JH, et al. Interval appendectomy after conservative treatment of an appendiceal mass. World J Surg. 2006; 30(3): 352- 357.
13. Bahram MA. Evaluation of early surgical management of complicated appendicitis by appendicular mass. Int J Surg. 2011; 9 (1): 101- 103.
14. Kaya B, Sana B, Eris C, Kutanis R. Immediate appendicectomy for appendicular mass. UlusTravmaAcilCerrahiDerg. 2012; 18(1): 71-74.
15. Garba ES, Ahmed A. Management of appendicealmass. Ann Afr Med. 2008; 7 (4): 200-204.
16. Cunnigaiper ND, Raj P, Ganeshram P, Venkatesan V. Does Ochsner-Sherren regimen still hold true in the management of appendicular mass? Turkish J Trauma &Emerg Surg. 2010; 16(1): 43- 46.
17. De U, Ghosh SA. Acute appendicectomy for appendicular mass: a study of 87 patients. Ceylon Med J. 2002; 47(4): 117-118.
18. Meshikhes AW. Appendiceal mass: is interval appendicectomy “something of the past”? World J Gastroenterol. 2011; 17(25): 2977-2980.
19. Meshikhes AW. Management of appendiceal mass: controversial issues revisited. J Gastrointest Surg. 2008; 12(4): 767-775.
20. Corfield L. Interval appendicectomy after appendiceal mass or abscess in adults: what is “best practice”? Surg Today. 2007. 37(1):1- 4.
21. Ahmed I, Deakin D, Parsons SL. Appendix mass: zdo we know how to treat it? Ann R Coll Surg Engl. 2005; 87: 191-195.