Appendectomy

Appendicitis is a condition in which the appendix becomes inflamed. The appendix is a finger or worm-shaped pouch that projects out from the cecum (the beginning of the colon). In most individuals, the appendix becomes inflamed because its tissues become infected with bacteria, and pus may develop within the lumen of the appendix. Mechanical blockage of the appendix by hard stool, a foreign body, or thick mucus may also lead to bacterial infections.

The signs and symptoms of appendicitis may include aching pain that begins around the umbilicus (belly button) and then shifts to the lower right abdomen. The pain may be sharp and can increase with movements such as walking or coughing. Many individuals may develop nausea, vomiting, loss of appetite, fever, constipation, inability to pass gas, and abdominal swelling. Individuals may also develop diarrhea.

A common sign of appendicitis is deep tenderness at the McBurney's point (the location of McBurney's point is about 2/3 the distance starting from the umbilicus to the right anterior superior iliac spine); however, young children and pregnant females may experience pain elsewhere in the abdomen.

Appendicitis Picture - Inflammation of the Appendix

Appendectomy is the surgical removal of the appendix. This procedure is most often performed as an emergency operation. Some patients undergoing abdominal surgery for another reason may have their appendix removed prophylactically so that appendicitis does not develop in the future; this option can be discussed with your surgeon.

The majority of appendectomy operations are typically emergency surgeries so the patient needs to follow the instructions given by the surgeon. In general, the patient is advised not to eat food, although, with the symptoms, they are usually not hungry anyway. The patient may be treated with medications to reduce or eliminate nausea and vomiting; IV antibiotics may also be initiated before surgery.

Appendectomy is most often done in the operating room after the patient's skin has been shaved to remove hair and swabbed with a germ-killing solution; sterility precautions are taken to prevent infection. The appendix may be removed by an open method or the laparoscopic technique. The open method requires a 2 to 3-inch incision in the lower right–hand side of the abdomen to remove the appendix, while the laparoscopic method uses several small incisions in the abdomen and the use of a laparoscope to visualize and then remove the appendix.

The recovery time for an appendectomy is variable and depends on the type of procedure, type of anesthesia, and any complications that may have developed. For example, laparoscopic appendectomy may be done on an outpatient basis so that the patient can be discharged to recover at home, while an open method may require an overnight stay or an even longer time to be discharged to go home. Normal activities can resume in a few days but full recovery may take 4 to 6 weeks during which time strenuous activity should be avoided.

Wound infection is the most common complication of an appendectomy. Abscess formation in the area of the removed appendix or surgical incision site may also occur.

 Other relatively infrequent complications may include:

• Ileus (lack of intestinal peristalsis)
• Surgical injuries to internal organs or structures
• Gangrene of the bowel
• Peritonitis (infection in the peritoneal cavity)
• Bowel obstruction

For most individuals, there are no long-term consequences of removing the appendix. However, some individuals may have an increased risk of developing an incisional hernia, stump appendicitis (infections due to a retained portion of the appendix), and bowel obstruction.