
Suggest Treatment For Appendicitis

Here's what my ultrasound report (USG Abdomen) said (only important paragraph): Small bowel is showing normal peristaltic activity under real time scanning. Right iliac fossa is showing rounded homogenous echogenic lesion with surrounding similar lobulated densities and inter-nodal encysted fluid. Probe tenderness is positive in region ? omental mass with fluid and mucoecle appendix. No retroperitoneal lymphadenopathy noted. All major vessels are of normal calibre and configuration.
My Haematology routine (blood test) is fine. Everything is within normal range in this report.
In Liver Function test S. Bilirubin (Total) is 1.01 mg/dl and Bilirubin indirect is 0.67 mg/dl.
S.G.O.T is 23 U/L.
S.G.P.T is 29 U/L.
Alkaline Phosphatase 160 U/L.
Total Proteins 7.4 gms/dl, albumin 5.2 gms/dl and globulin 2.2 gms/dl. Hence A:G Ratio is 2.36.
Now after taking medicines prescribed by my doctor, I dont have any pain. My doctor said I still need to have an appendectomy after 3 months.
I just want a second opinion. Do I really need a surgery? If yes then why after 3 months and why not right now??
Also, now as I dont have any pain after taking the medicines and my surgery will happen after three months, can I drink alcohol? or smoke? or should I wait for sometime? If I'm allowed to drink/smoke, then is there any limit?
There is more risks in doing surgery now and therefore given 3 months gap
Detailed Answer:
Hi XXXX,
Thanks for writing in.
I have read through your query in detail.
In ultrasound, there is a possibility of a small "mass" formation around the appendix with the appendix itself filled up with mucus material and some fluid collection around it.
From the above I would suggest doing a CT scan abdomen to get a more clear picture about the "omental mass" mentioned in your report and confirm the ultrasound findings.
Regarding surgery, usually surgery is postponed if there is any appendicular mass present. This is to minimize the complications. Formation of a mass is seen in many cases and then initially this is treated with antibiotics and after 3 months an elective surgery is done.
Smoking does not have any thing specific to do with your condition but you must stop smoking just before your surgery. Intake of alcohol is can be taken in little quantities and also must be stopped just before surgery.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek

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