CONSERVATIVE MANAGEMENT VERSUS EARLY INTERVENTION OF APPENDICULAR MASS

Abstract

Appendicular mass is a localized complication of acute appendicitis, commonly arising in patients with delayed presentation. Its management remains controversial, with traditional conservative treatment (Ochsner-Sherren regimen) being challenged by increasing evidence in favor of early surgical intervention.This prospective comparative study was conducted at Abbasi Shaheed Hospital, Karachi, over a 12-month period. A total of 80 patients aged 23–65 years with radiologically confirmed appendicular mass were included and randomly assigned to two groups: Group A received conservative management with antibiotics, bowel rest, and supportive care, while Group B underwent early appendectomy within 24–48 hours. Outcomes assessed included recovery time, recurrence, treatment failure, complications, pain scores, hospital stay, and the need for subsequent surgery. Data were analyzed using SPSS version 24, with a p-value <0.05 considered statistically significant.Early appendectomy demonstrated superior outcomes compared to conservative management. Patients in the surgical group had a significantly shorter recovery time (21.8 ± 1.7 vs. 30.5 ± 2.0 days, p=0.026), lower recurrence risk (0.77% vs. 31.2%, p<0.001), and lower failure rate (2.1% vs. 33.8%, p<0.001). Postoperative pain scores and complication rates were also significantly reduced in the surgical group. In contrast, conservative management was associated with higher recurrence, longer recovery, and increased hospital burden.Early appendectomy provides a more definitive and effective treatment for appendicular mass, resulting in shorter recovery, fewer complications, and reduced recurrence compared to conservative management. These findings support early surgical intervention as the preferred strategy in tertiary care settings, particularly in populations where delayed presentation and limited follow-up compliance are common.