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Appendectomy

Definition

An appendectomy is surgery to remove the appendix.

See also: Appendicitis

Alternative Names

Appendix removal

Description

The appendix is a small, finger-shaped organ extending from the first part of the large intestine. It is removed when it becomes inflamed or infected. A perforated appendix can leak and infect the entire abdominal area, which can be life-threatening. See: Peritonitis

An appendectomy is done under general anesthesia, which means you are asleep and do not feel any pain during the surgery. The surgeon makes a small cut in the lower right side of your belly area and removes the appendix.

The appendix can also be removed using minimally invasive techniques. This is called a laparoscopic appendectomy. It is performed with small incisions and a camera.

If the appendix ruptured or a pocket of infection (abscess) formed, your abdomen will be thoroughly washed out during surgery. A small tube may be left in the belly area to help drain out fluids or pus.

Why the Procedure Is Performed

The symptoms of appendicitis vary. The condition can be hard to diagnose, especially in children, the elderly, and women of childbearing age.

Most often, the first symptom is pain around your belly button.

• The pain may be vague at first, but it becomes sharp and severe.
• The pain often moves into your right lower abdomen and becomes more focused in this area.

Other symptoms include:

• Fever (usually not very high)
• Reduced appetite
• Nausea and vomiting

If you have symptoms of appendicitis, seek immediate medical help. Do not use heating pads, enemas, laxatives, or other home treatments to try and relieve symptoms.

Your health care provider will examine your abdomen and rectum. Other tests may be done.

• Blood tests, including a white blood cell count (WBC), may be done to check for infection.
• When the diagnosis is not clear, the doctor may order a CT scan or ultrasound to make sure the appendix is the cause of the problem.

There are no actual tests to confirm that you have appendicitis. Other illnesses can cause the same or similar symptoms.

The goal is to remove an infected appendix before it breaks open (ruptures). After reviewing your symptoms and the results of the physical exam and medical tests, your surgeon will decide whether you need an operation.

Even when the surgeon discovers the appendix is not infected, it will be removed 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

Other risks with an appendectomy after a ruptured appendix include the following:

• Longer hospital stays
• Side effects from medications

After the Procedure

Patients tend to recover quickly after a simple appendectomy. Most patients leave the hospital in 1 - 3 days after surgery. You can resume normal activities within 2 - 4 weeks after leaving the hospital.

Recovery is slower and more complicated if the appendix has ruptured or an abscess has formed.

Living without an appendix causes no known health problems.

References

Wolfe JM, Henneman PL. Acute appendicitis. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 91.

Howell JM, Eddy OL, Lukens TW, Thiessen ME, Weingart SD, Decker WW; American College of Emergency Physicians. Clinical policy: Critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med. 2010;55:71-116.