Alternative Names: Appendix removal

Description:

The appendix is a small, finger-shaped pouch of intestinal tissue extending from the cecum, which is the first part of the large intestine. Blockage of the opening of the appendix into the bowel by a hard small stool fragment (fecalith) is believed to be a frequent cause of appendicitis.

The infected appendix must be surgically removed (emergency appendectomy), because if it becomes perforated (leaks), this can lead to infection of the entire abdominal space (peritonitis), which can be fatal.

The surgery is done while the patient is unconscious and pain-free, using general anesthesia. A small incision is made in the right lower quadrant of the abdomen, and the appendix is removed. Alternatively, the appendix may be removed laparoscopically with a smaller incision, using a tiny camera to visualize the area.

If a pocket of infection -- an abscess -- has formed, or the appendix has ruptured, the abdomen will be thoroughly washed out during surgery, and a small tube may be left in to help drain out fluids or pus.

Indications:

Appendix removal is necessary in cases of acute appendicitis. Symptoms of acute appendicitis include:

• Abdominal pain (located in the lower right side)
• Fever
• Reduced appetite
• Nausea and vomiting

Your health care provider will:

• Check your abdomen for tenderness and tightness
• Check your rectum for tenderness and an enlarged appendix
• Check your blood for an increase in white blood cells (WBC)

Imaging studies will likely be used.

There is no test to confirm appendicitis, and the symptoms may be caused by other illnesses. The health care provider must diagnose the condition based on the information you report and what is found by tests and physical examination.

Even if the surgeon finds that the appendix is not infected (which happens up to 25% of the time), the other abdominal organs will be thoroughly checked, and the appendix will be removed anyway in order to prevent future problems.

Risks:

Risks for any anesthesia include the following:

• Reactions to medications
• Problems breathing

Risks for any surgery include the following:

• Bleeding
• Infection

Additional risks with an appendectomy with ruptured appendix include the following:

• Longer hospital stays
• Antibiotic treatment

CAUTION:

Untreated acute appendicitis can be deadly. If you have symptoms suggestive of appendicitis (pain in the lower right abdomen, fever, loss of appetite, nausea, vomiting)

• SEEK EMERGENCY HEALTH CARE PROMPTLY -- see your doctor immediately, call 911 or other local emergency number, or get to the emergency room.
• DO NOT use heating pads, enemas, laxatives, or other home treatments.

Expectations after surgery:

Recovery from a simple appendectomy is usually complete and rapid. If the appendix has developed an abscess or ruptured, the recovery will be slower and more complicated, requiring use of medications to treat the infection (antibiotics).

Living without an appendix causes no known health problems.

Convalescence:

Convalescence is usually short, and most patients leave the hospital in 1 - 3 days after the operation. Normal activities can be resumed within 1 - 3 weeks after leaving the hospital.