Appendectomy

Man holding sore stomach

An appendectomy is a surgical procedure to remove the appendix when it is infected and inflamed.

What is the appendix and appendicitis?

The appendix is a small (three and a half inches), thin, tube-shaped pouch that is attached to our large intestine and sits in the lower right-hand side of our body.

Appendicitis is a condition where the appendix becomes inflamed. Inflammation can occur as a result of blockage of the appendix by feces, a foreign object, or by a tumor. The appendix can also swell in response to any infection in the body and this can also result in a blockage.

What are the symptoms of appendicitis?

Common symptoms of appendicitis may include:

  • Pain in the lower right-hand side of the abdomen or near the belly button that moves lower
  • Nausea and vomiting
  • Loss of appetite
  • Bloating
  • Gas build-up
  • Fever.

Some people may experience referred pain (that feels like it is in the upper belly, back, or rear end), pain or difficulty passing urine, severe cramps, constipation or diarrhea.

There is a serious risk that your appendix can burst if you have appendicitis; sometimes as soon as 48 to 72 hours after symptoms start. This can lead to life-threatening complications.

How is appendicitis diagnosed?

Seek medical advice straight away if you are having symptoms that could be appendicitis. Diagnosing appendicitis can be difficult because symptoms are like other conditions such as Crohn’s disease, gallbladder disease, gastritis, kidney stones, ovarian disease, or urinary tract or intestinal infections.

Your doctor will take a history and perform a physical examination. They will conduct some blood tests and other tests to rule out other conditions such as a urinary tract or other infection. An ultrasound or CT scan may also be performed.

If appendicitis is diagnosed, your doctor will refer you for treatment.

When is an appendectomy performed?

An appendectomy is considered the standard treatment for appendicitis. It is usually done as emergency surgery because there is a risk that the appendix can rupture if there is any delay in performing the surgery. A ruptured appendix spreads bacteria and fecal matter into the abdomen and can cause a serious infection called peritonitis. An abscess may also form in the appendix if it is not treated promptly. Both of these situations can be life-threatening and require emergency surgery.

There are two types of surgery to remove the appendix:

  • Open appendectomy: A 2 to 4-inch cut is made in the abdomen wall and the appendix is removed through this cut.
  • Laparoscopic appendectomy: This is a less invasive, more modern procedure that may cause less pain and scarring, shorter hospital stays and less risk of infection. However, it may not be suitable for everyone, especially if the appendix has already ruptured. Small cuts are made in the abdomen wall and a long thin tube called a laparoscope is passed into the abdomen. The laparoscope contains a camera and surgical tools that allow the surgeon to remove and extract the appendix. Sometimes during laparoscopic surgery, an open appendectomy is needed.

Some recent studies have shown that intravenous antibiotics are effective at relieving appendicitis without the need for surgery. However, these results remain controversial and appendectomy remains the preferred treatment.

    What risks are associated with an appendectomy?

    Appendectomy is considered a low-risk procedure, but risks increase if the appendix has ruptured before surgery or ruptures during surgery.

    Other risks include:

    • Bleeding
    • Blocked bowels
    • Injury to surrounding structures and organs
    • Wound infection.