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Of 834 children who had appendicectomy for appendicitis 77 (9.2%) had developed an appendix mass when first seen. Under 6 years of age 25% of appendicitis patients had an appendix mass at presentation and almost 60% of the masses seen were in patients under six years of age. Forty three of the 77 masses (55%) were palpable only under anaesthesia. The masses were all initially managed conservatively by bed rest, intravenous fluids and intravenous antibiotics. All but eight (10%) of the 77 patients responded to this form of treatment. Interval appendicectomy was planned for a date 4 weeks following discharge. The overall total average bed stay including interval appendicectomy was 16 days. There were no late complications or relaparotomies.

A commintment to the concept of total patient care requires consideration of the social and emotional, as well as the physical, problems of the patient. Assessing the quality of the social work service--including adequate attention to problem evaluation, social treatment, and outcome--can help to assure that patients will return to as high a level of social functioning as possible.