Appendicitis and Appendectomies

The appendix is a three to six inch long structure that attaches at the junction of the small and large intestine. It has no known function, but can become inflamed and need to be removed. This is done through a procedure called an appendectomy. The inflammation and pain associated with an unhealthy appendix is called appendicitis.

Appendicitis can occur because of fecal matter obstruction, but this is not always the case. It usually develops within six to 12 hours without warning. Symptoms of appendicitis include abdominal pain that begins mildly around the navel and increases over the course of several hours. The abdomen may also become rigid and sensitive to pressure. These symptoms are typically accompanied by loss of appetite, nausea, or vomiting. If left untreated, appendicitis can lead to a ruptured appendix and serious infection.

Approximately two-thirds of people who develop appendicitis are female. Most are between the ages of 15 and 44. Diagnosis is based primarily on reported symptoms and a quick physical exam. Sometimes a patient’s white blood count is elevated. If the condition is urgent with severe pain and concern for rupture, surgery is performed as soon as possible. Otherwise, further testing can be ordered to confirm diagnosis.

Treatment

Appendectomies are performed under general anesthesia. It can be completed through an open operation or laparoscopic surgery. During open surgery, a short incision is made in the skin and fat, and the muscles of the abdominal wall are separated. This allows for entry into the abdominal cavity and extraction of the appendix. Following removal, the abdominal wall is closed and the tissue is sutured. In rare cases when the appendix has ruptured, the skin may be left open temporarily to prevent infection.

During the laparoscopic procedure, a camera is inserted through a small incision in the umbilicus. This is used to view the abdominal cavity. Surgical instruments are inserted through two small incisions. This method allows for quicker healing and less pain.

Recovery

Recovery time is short and patients are typically walking within six hours. If surgery goes well, patients return home within a day or two of the procedure. If the appendix has ruptured, a longer hospital stay is required. Pain is minimal in most cases and treated with oral pain medication.

Appendectomies are considered safe, but as with all surgeries, there are some risks involved. These include:
  • Infection of abdominal cavity or wall (most common after a rupture)
  • Misdiagnosis
  • Bleeding
  • Injury to Organs
  • Issues with laparoscopic surgery that requires transition to open surgery