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Background: Acute appendicitis is the most common abdominal condition necessitating urgent surgical intervention in the United States. The objective of this study was to determine if interval laparoscopic appendectomy after initial nonoperative treatment for late appendicitis presenting as an appendiceal mass is a safe alternative to immediate appendectomy. Methods: Thirty two consecutive patients (aged 16–74 years) during a 5-year period presented with appendiceal mass. Seventeen received initial nonsurgical treatment followed by interval laparoscopic appendectomy (aged 16–60 years; group 1). Fifteen underwent immediate appendectomy (aged 16–74 years; group 2). Results: All patients in the interval laparoscopic appendectomy group improved with initial therapy and underwent surgery an average of 4.9 months later. Although the operative time and the complication rate were similar between groups 1 and 2, the time to return to baseline activities was significantly less in group 1 after adjusting for age (p = 0.02 or less). Conclusions: Interval laparoscopic appendectomy is safe in patients with chronic appendicitis and allows for judicious diagnostic evaluation of the appendiceal mass and planned surgery under controlled conditions.

Results are reported from computations of tidal heating processes in a realistic three-layer Europa model featuring an elastic ice lithosphere, an underlying inviscid water layer, and an elastic silicate core. The volumic density of the outer two layers were 940 and 1000, respectively, while the Europan mean density was 3030 kg/cu m and the total depth of the water layers was 100 km. Calculations of various thermal distributions in the liquid layer, heated tidally by the core, indicate that a decoupled ice lithosphere would be distorted by 23 m at the sub-jovian point, which would correspond with a Love number of 0.26. The tidal heating scenario does not explain the observed recent cracking of Europa's surface, unless the satellite also recently had a significantly more eccentric orbit.