2 PI24 CIRUGA GENERAL Patologa apendicular Masas apendiculares

Overview of Appendicular Masses

Types of Appendicular Masses

• Appendicular masses can be classified as plastrons (non-abscessed) or abscesses (abscessed) based on their characteristics.

• Both types are associated with the clinical progression of appendicitis, typically presenting after about four days of illness.

Clinical Presentation and Diagnosis

• It is uncommon for a plastron to develop within the first two to three days; usually, it appears from the fourth day onward, accompanied by a palpable mass.

• The preferred diagnostic study for suspected appendicular masses is CT scan, applicable across all age groups except pregnant women, where ultrasound is recommended instead.

Treatment Approaches

Management of Plastrons and Abscesses

• Treatment varies: if only a plastron is present without pus, management involves antibiotic therapy lasting approximately two weeks. If an abscess is present, drainage is necessary.

• Percutaneous drainage under CT guidance is ideal; surgical intervention may be required in some cases but should generally be avoided initially.

Timing for Appendectomy

• In both scenarios (plastrons and abscesses), appendectomy should be deferred—typically considered around six weeks post-treatment to prevent recurrence of appendicitis. This approach allows for proper healing before surgery.