STUDIES ON APPENDICITIS WITH A PALPABLE MASS TREATED BY BOWEL RESECTION

Eleven cases of appendicitis with a palpable mass treated by combined bowel resection were retrospectively studied. The indications for combined bowel resection were the direct spread of appendiceal infection to the cecum in 2 cases; abscess formation in the posterior portion of the cecum, with the ileal region becoming a mass due to the inflammatory tumor in 3 cases; appednicitis with tumor formation in 2 cases; and malignant tumor in 2 cases. Of the remaining two patients, one underwent reoperation for intestinal fistula and the other for an inflammatory tumor resulting from the inflammation remaining in the cecum. While combined enterectomy should be avoided for benign appendicitis, however extensive the inflammation may be, we occasionally select this procedure for advanced appendicitis with a palpable mass. In such cases, appendectomy is performed if possible, and if impossible, drainage or combined bowel resection is selected for appendicitis spreading to the cecum and for that with abscess formation. Combind bowel resection is carried out for appendicitis with tumor formation and suspected malignant tumors.