Suggest Treatment For Perforated Appendix
IS SURGERY ABSOLUTELY NECESSARY AND CAN THIS BE DONE LAPAROSCOPICALLY? WHAT ARE THE CONSEQUENCES OF REFUSING SURGERY? AM NOW ASYMPTOMATIC AND DO NOT WANT TO GO THROUGH THIS. BY THE WAY, HAD A COLONOSCOPY ALSO THIS ADMISSION WHICH WAS ABSOLUTLEY NEGATIVE.
as explained in details.
Thanks for your query.
To recapitulate: Male/68 - admitted with possible perforated appendix with hard area - on antibiotics - tolerating food - asymptomatic - wants to know further.
To answer your queries:
- It takes about 3-6 weeks for the things to become normal.
- As per the history you have provided, this looks to be perforated appendix with appendicular mass formation. It takes about 3 to 6 weeks for resolution - surgery is performed as a planned case in such a situation as it is very difficult and can be messy surgery due to either adhesion and/or friability of the tissue is increased.
- Hence if you are improving symptomatically and signs wise, if there is no formation of appendicular abscess, the conservative management has to be continued and surgery to be planned preferably after 6 weeks to avoid any complications.
- Surgery is absolutely necessary as you can have further attack any time.
- Surely it can be done by Laparoscopy.
- Refusing surgery: If there is appendicular abscess formation, immediate surgery will be required to save life. If you respond well to the conservative management as you are now as per the history you have provided, interval appendectomy should be done so as to avoid the further attack.
I hope this answers your query. Please feel free to ask for further relevant queries if you feel that there is a gap of communication.