APPENDICEAL MASS: DIAGNOSTICS AND TREATMENT STRATEGY.
N A MaistrenkoP N RomashchenkoM V YaginPublished in: Vestnik khirurgii imeni I. I. Grekova (2018)
One of the frequent complications of acute appendicitis
is appendiceal mass (AM). This research aimed to specify the
criteria of AM diagnostics and determine the rational treatment
strategy. It was stated that the duration of disease more
than 3 days in combination with palpable infiltrate in the right
iliac region and absence of positive appendiceal signs allowed
formation of the clinical diagnosis of dense AM and definition
of the following diagnostics program. An application of ultrasound
study gave the possibility to differentiate AM according
to maturity into loose and dense cases. Сomputer tomography
and irrigoscopy were used routinely in controversial сases of
differential diagnostics of dense AM and oncological diseases
of the right areas of the large intestine. Diagnostic laparoscopy
should be rational in patients with uncertain clinical findings during
dynamic monitoring of imaging of inflammatory infiltrate in
the right iliac region and it could facilitate to assess of the possibility
of its safe separation. The application of given method of
dia gnostics algorithm determined the treatment strategy: laparoscopic
appendectomy in case of loose AM and conservative
therapy in case of dense AM.