A 26-year-old male presented with 4 day history of pain in the right sided lower abdomen with frequent vomiting. Patient's general condition is fair and clinically a tender lump was felt in the right iliac fossa. Most appropriate management for this case would be:
Ans. (c) Ochsner-Sherren regimenOchsner-Sherren regimen:* Advised in appendicular mass -- as the inflammatory process is localized with full of adhesions and if we try to remove appendix, we will cause bowel injury and result in enterocutaneous fistula.* This management includes -- nil oral, IV fluids, antibiotics and observation of input, output and abdominal girth chart.* Clinical improvement seen in 24-48 hours.* If there is no improvement take CECT abdomen and if there is abscess drain it radiologically.* Interval appendectomy done after 6 weeks* Criteria to stop Ochsner regimen:* Increasing pulse rate* Increasing abdominal girth chart* Increasing mass size
Exploratory laparotomy
Immediate appendectomy
Ochsner-Sherren regimen
External drainage
Small & Large Intestine