Surgical Outcomes of Emergency Appendectomy for Appendicular Mass in a Resource-Limited Setting: A Prospective Observational Study

Export Objective: Appendicitis is a common surgical disease. An a ppendicular mass is a serious complication that frequently arises from delayed presentation. In countries with limited resources, such as Yemen, there is a dearth of information regarding the clinical features, intraoperative findings, and outcomes of appendicular mass. In a setting with limited resources, this study sought to assess the clinical presentations, intraoperative findings, postoperative outcomes, and factors linked to complications in patients with appendicular masses undergoing surgical therapy. Methods: From January 1, 2023 to December 30, 2023, 70 patients with appendicular masses at a Yemeni tertiary care hospital participated in a prospective observational study. We gathered information on surgical procedures, postoperative results, laboratory findings, intraoperative findings, clinical presentations, and demographics. We examined correlations between complications and variables including white blood cell (WBC) count and duration of illness. Results: Most patients were between the ages of 10 and 20 (60%) and were more likely to be male (1.3:1). In 45.7% of cases, delayed presentation (≥3 days) was noted, and it was substantially linked to complex appendicitis (P=0.001). The most frequent intraoperative discovery was suppurative appendicitis (45.7%), followed by appendicular mass (27.1%). Postoperative problems occurred in 35.7% of patients, with wound infections accounting for the majority (31.4%). Complications were significantly associated with elevated white blood cell (WBC) counts (≥16,000/mm3, P = 0.05). Although the average hospital stay was 3.4 days, 54.3% of patients were discharged within 2 days. Conclusions: Complicated appendicitis and surgical complications are significantly predicted by delayed presentation and increased WBC levels. Improved results require better infection control procedures in addition to early detection and response. To address the high burden of complications associated with appendicular mass, this study highlights the necessity of tailored management strategies in environments with limited resources. The viability of laparoscopic procedures and their long-term results in such situations require further investigation.