Appendix: appendicular mass: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Appendix: appendicular mass

Sample item

A 25-year-old presents on day 5 of right iliac fossa pain with a tender, ill-defined mass, mild fever and no peritonitis. What is the preferred management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Conservative (Ochsner-Sherren) regimen, with interval appendicectomy later

An appendicular mass is omentum and bowel walled off around an inflamed appendix. Early surgery is hazardous, so patients are given intravenous fluids, antibiotics and monitoring, and interval appendicectomy follows in about six to eight weeks. Surgery or drainage is needed if the mass enlarges, an abscess forms or peritonitis develops.

Option by option

  • A. Immediate laparotomy and appendicectomy

    Early surgery in a mass risks bowel injury and faecal fistula.

  • B. Right hemicolectomy

    Hemicolectomy is not indicated for a standard mass.

  • C. Discharge without follow-up

    Follow-up is needed because recurrence and missed neoplasm are possible.

  • D. Conservative (Ochsner-Sherren) regimen, with interval appendicectomy later (correct)

    Correct. A stable patient with a mass is managed conservatively first.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Conservative (Ochsner-Sherren) regimen, with interval appendicectomy later. An appendicular mass is omentum and bowel walled off around an inflamed appendix.

Why is "Immediate laparotomy and appendicectomy" not the answer?

Early surgery in a mass risks bowel injury and faecal fistula.

Why is "Right hemicolectomy" not the answer?

Hemicolectomy is not indicated for a standard mass.

Why is "Discharge without follow-up" not the answer?

Follow-up is needed because recurrence and missed neoplasm are possible.

What concept does this question test?

It tests Appendix: appendicular mass in General Surgery. Early surgery is hazardous, so patients are given intravenous fluids, antibiotics and monitoring, and interval appendicectomy follows in about six to eight weeks. Surgery or drainage is needed if the mass enlarges, an abscess forms or peritonitis develops.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Appendix: appendicular mass?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.