Appendectomy

Alternative names

Appendix removal

Definition

An appendectomy is the surgical removal of an inflamed or infected appendix (appendicitis).

Description

The appendix is a small, finger-shaped pouch of intestinal tissue extending from the cecum, which is the first part of the large intestine. Blockage of the opening of the appendix into the bowel by a hard small stool fragment (fecalith) is believed to be a frequent cause of appendicitis.

The infected appendix must be surgically removed (emergency appendectomy), because if it becomes perforated (leaks), this can lead to infection of the entire abdominal space (peritonitis), which can be fatal.

The surgery is done while the patient is unconscious and pain-free, using general anesthesia. A small incision is made in the right lower quadrant of the abdomen, and the appendix is removed. Alternatively, the appendix may be removed laparoscopically with a smaller incision, using a tiny camera to visualize the area.

If a pocket of infection - an abscess - has formed, or the appendix has ruptured, the abdomen will be thoroughly washed out during surgery, and a small tube may be left in to help drain out fluids or pus.

Indications

Appendix removal is necessary in cases of acute appendicitis. Symptoms of acute appendicitis include:

• Abdominal pain (located in the lower right side)
  
• Fever
  
• Reduced appetite
  
• nausea and Vomiting
  

Your health care provider will:

• Check your abdomen for tenderness and tightness
  
• Check your rectum for tenderness and an enlarged appendix
  
• Check your blood for an increase in white blood cells (WBC)
  

Imaging studies will likely be used.

There is no test to confirm appendicitis, and the symptoms may be caused by other illnesses. The health care provider must diagnose the condition based on the information you report and what is found by tests and physical examination.

Even if the surgeon finds that the appendix is not infected (which happens up to 25% of the time), the other abdominal organs will be thoroughly checked, and the appendix will be removed anyway in order to prevent future problems.

Risks