This overview is a sample of the type of information available to you at Griffin Hospital's Community Health Resource Center. It is not intended to replace your physician's instructions in the management of your health problems, but to better inform you about a particular illness and alert you to the availability of other materials. If you have a question about any piece of information presented in theses fact sheets, please call your physician, or stop by the Community Health Resource Center at your convenience.

APPENDECTOMY

WHAT AN APPENDECTOMY?

The appendix is a small tube or pouch, about 3-1/2 inches long in an adult, that is an offshoot of the large intestine. Although everyone is born with one, the appendix performs no known function. Occasionally the appendix becomes inflamed or infected which causes appendicitis. An appendectomy is the surgical removal of the appendix which is done to treat appendicitis. If the appendicitis is left untreated, it can become life-threatening.

WHAT ARE THE SYMPTOMS OF AN APPENDICITIS?

The symptoms of appendicitis vary and depend on where your appendix is located. Usually your appendix sits in the lower right-hand side of your abdomen, but it can be found almost anywhere in the abdomen. In over half of acute appendicitis attacks, the pain begins around the navel and eventually moves to the right side of the lower abdomen. Sometimes you will experience only slight abdominal pain, but a lot of rectal pain. You may have a slight fever with nausea and vomiting after the pain has started. Your abdomen will probably be quite tender when the doctor examines it. You will almost always have a loss of appetite.

WHAT CAUSES AN APPENDICITIS?

Bacteria or a virus can cause an infection of the appendix, or the appendix can become blocked by hard, dry stool. Sometimes a cause can't be found. Appendicitis occurs most frequently between the ages of 10 and 30, but can happen in any age group. Appendicitis is the most common cause of abdominal surgery in children.

DIAGNOSIS

The diagnosis of appendicitis can be difficult to make because the symptoms imitate many other disorders. No definite test can be done to prove the diagnosis of appendicitis. The diagnosis is usually made from the symptoms and proved by laparotomy (surgically looking into the abdomen). Right lower abdominal pain and tenderness, slight fever, nausea and loss of appetite form the "classic picture" of acute appendicitis. Blood tests may show a normal or only slightly higher white blood cell count. (A high white blood cell count indicates an infection.) An abdominal x-ray is usually not helpful. Occasionally ultrasound (sonography) is useful in determining the diagnosis.

WHAT IS THE PURPOSE OF AN APPENDECTOMY

An appendectomy is done to remove the infected appendix. If left in the abdomen, it can perforate (burst) and cause peritonitis, an inflammation of the lining of the abdomen. If peritonitis is not treated, it can be life-threatening.

WHAT TO EXPECT BEFORE SURGERY

The symptoms may be vague during the first 8 to 12 hours of an acute attack of appendicitis. Your doctor will check you frequently, examining your abdomen and possibly repeating blood tests. You will not be able to eat or drink anything and will be asked to stay in bed. A chest x-ray, urine test and abdominal x-ray are usually done. Occasionally, a tube will be placed through your nose into your stomach to help drain your stomach contents. An IV (intravenous line) may be started so you can receive fluids and medications. If there is time before surgery, antibiotics may be started to help prevent infection.

WHAT TO EXPECT DURING SURGERY

You will be taken on a wheeled stretcher where the operating room staff will greet you. The air temperature will be much cooler in the operating room. The surgeons need to keep the room cool because so much heat is produced by the bright operating room lights. Your anesthesiologist or anesthetist will give you medicine in your IV to make you sleep. After you are asleep, a breathing tube may be placed in your windpipe (endotracheal tube) to assist your breathing. Your anesthesiologist or anesthetist can give you an anesthetic gas to breathe through this endotracheal tube which will put you into a deeper sleep for the surgery. You may have a sore throat from the endotracheal tube for a few days after surgery.

Your doctor will remove your appendix through a small incision in your abdomen. If your appendix has perforated (burst), then the inside of your abdomen will be washed out with saline (a salt solution) and a drainage tube may be placed through another small incision. A drainage tube helps drain fluid away from the site and decrease the swelling that sometimes occurs. You will be in surgery from 30 minutes to more than an hour, depending on the condition of your appendix.

WHAT TO EXPECT AFTER SURGERY

Usually you will be able to drink and eat light foods within 24 hours after surgery. It will take a while for your appetite to return. If you have a drainage tube in your abdomen, it will be removed about two days after surgery. Your stitches will be removed in about 7 to 10 days in your doctor's office. Your hospital stay will usually be between 3 and 7 days.

Watch for signs of infection such as drainage from your incision, fever, increased pain, tenderness or bleeding. Call your doctor if any of these occur.

When you first get home, it is normal to feel very tired. It may take a few weeks to start feeling more like yourself. You can resume normal activities after about three weeks, but try to avoid strenuous exercise for about six weeks. Your doctor will let you know when you can start driving a car again. Remember, no lifting.

Your doctor will give you a prescription for pain pills to take at home to help ease your discomfort. He or she may also prescribe antibiotic pills to help prevent infection. Your doctor and nurse will explain any medications you are given. If you have any questions, feel free to ask. The good news is ... once your appendix has been removed, you'll never have appendicitis again.

Please note that this information is intended to give you a general overview of the topic. It is not intended to replace advice or instruction of a health professional. We recommend that you consult your physician, nurse, or qualified health professional regarding the information in this publication. © 1994 Planetree, Inc. Reproduction of this material in any form is limited to license agreement.

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