Appendix removal; Surgery - appendectomy; Appendicitis - appendectomy
An appendectomy is surgery to remove the appendix.
Appendectomy, the removal of the small pouch attached to the beginning of your large intestine when you have an acute bout of appendicitis is one of the most common emergency abdominal surgeries. The appendix is a small, finger-shaped organ that comes out of the first part of the large intestine. It needs to be removed when it becomes swollen or infected. If the appendix is not removed, it can leak bacteria and infect your entire belly, which can be very life threatening. So, what are the signs that you have appendicitis? Well, this condition can be fairly hard to diagnose, especially in children, older people, and women of childbearing age. Usually, the first symptom is pain around your belly button. The pain might be mild at first, but then it gets sharp and severe before not too long. The pain may then move into your right lower abdomen. You may also have diarrhea, fever, nausea, and a reduced appetite. Sometimes, people think that they might be having food poisoning. Your doctor will make a diagnosis based on your symptoms. You may also have blood tests and a CT scan or ultrasound. Once it's clear that you have appendicitis, your doctor will probably schedule you for emergency surgery. In surgery, you will receive anesthesia and be asleep and pain free. The doctor will make a small cut in the lower right side of your belly and remove your appendix. If the surgeon uses the laparoscopic technique, you will have several small cuts in your abdomen for the surgical instruments. If your appendix broke open, or a pocket of infection has formed, your doctor will wash out your belly during the surgery. A small tube may remain to help drain out fluids or pus. Once you've had an appendectomy, you will probably recover pretty quickly. It feels good to get a bad appendix out. Most patients leave the hospital 1 to 2 days after surgery. The good news is that you'll be able to go back to all those normal activities within 2 to 4 weeks.
The appendix is a small, finger-shaped organ that branches off from the first part of the large intestine. When it becomes swollen (inflamed) or infected, the condition is called appendicitis. When you have appendicitis, your appendix may need to be removed. An appendix that has a hole in it can leak and infect the entire abdomen area. This can be life threatening.
Appendectomy is done using either:
- Spinal anesthesia -- Medicine is put into your back to make you numb below your waist. You will also get medicine to make you sleepy.
- General anesthesia -- You will be asleep and not feel any pain during the surgery.
The surgeon may make a small cut in the lower right side of your belly area and remove the appendix.
The appendix can also be removed using small surgical cuts and a camera. This is called a laparoscopic appendectomy.
If the appendix broke open or a pocket of infection (abscess) formed, your abdomen may be washed out during surgery. A small tube may be left in the belly area to help drain out fluids or pus.
You may never have given much thought to your appendix, the little pouch that's attached to the top of your large intestine. And you wouldn't have much reason to think about it, because it doesn't seem to do anything. But if your appendix were to become swollen and inflamed, it would probably move to the front of your mind. The pain of appendicitis can make you quickly, and unpleasantly, familiar with this organ. You can get appendicitis if your appendix becomes blocked. That blockage could be from feces, a foreign object, or, in rare cases, a tumor. When your appendix is blocked up, bacteria that normally live inside it start multiplying like crazy, and cause an infection. If you've got appendicitis you'll usually have pain that's centered around the area of your belly button. At first the pain may be minor, but it can get very severe and will usually drift downward to the bottom right part of your abdomen. You may also have nausea, vomiting, diarrhea or constipation, and a low fever. Your pain may let up for a time. This relief can be misleading, though. Just when you think you're getting better, your appendix may have actually burst. If that's the case, the pain will get start to get more and more intense. To diagnose appendicitis, your doctor will ask about your symptoms and press on your abdomen, which will feel very tender. You may need imaging tests, such as a CT scan or ultrasound of your abdomen, so the doctor can see if the problem is with your appendix. If you have appendicitis, the number one way to treat it is with surgery to remove your appendix. In fact, appendicitis is the number one cause of emergency abdominal surgery in the U.S. You may be treated for an infection first, before your surgery. It's important to treat the appendicitis quickly because you can develop a collection of pus called an abscess in your abdomen once your appendix bursts. Don't worry about going through life without an appendix. People live healthy lives without it. Once you've had your appendix taken out, you should feel a lot better. If your appendix has ruptured, it may take you longer to recover. You may also develop an abscess or other complications. That's why you don't want to wait until your appendix has already burst to get treated. Call your doctor for any severe pain in your abdomen, especially if you also have a fever, vomiting, constipation, dizziness, or other severe symptoms.
Why the Procedure Is Performed
An appendectomy is done for appendicitis. The condition can be hard to diagnose, especially in children, older people, and women of childbearing age.
Most often, the first symptom is pain around your belly button:
- The pain may be mild at first, but it becomes sharp and severe.
- The pain often moves into your right lower abdomen and becomes more focused in this area.
Other symptoms include:
- Diarrhea or constipation
- Fever (usually not very high)
- Nausea and vomiting
- Reduced appetite
If you have symptoms of appendicitis, seek medical help right away. Do not use heating pads, enemas, laxatives, or other home treatments to try to relieve symptoms.
Your health care provider will examine your abdomen and may perform a rectal exam and pelvic exam. Other tests may be done:
- Blood tests, including a white blood cell count (WBC), may be done to check for infection.
- The provider may order a CT scan or ultrasound to make sure the appendix is the cause of the problem since other illnesses can cause the same or similar symptoms.
The goal is to remove an infected appendix before it breaks open (ruptures). After reviewing your symptoms and the results of the physical exam and medical tests, your surgeon will decide whether you need surgery.
Risks of anesthesia and surgery in general include:
- Reactions to medicines
- Problems breathing
- Bleeding, blood clots, or infection
Risks of an appendectomy after a ruptured appendix include:
- Buildup of pus (abscess), which may need draining and antibiotics
- Infection of the incision
After the Procedure
Most people leave the hospital in 1 to 2 days after surgery. You can go back to your normal activities within a few weeks after leaving the hospital though it may take several weeks to get back to your normal energy level.
If you had laparoscopic surgery, you will likely recover quickly. Recovery is slower and more complicated if your appendix has broken open or an abscess has formed.
Living without an appendix causes no known health problems.
Quick CRG, Biers SM, Arulampalam THA. Appendicitis. In: Quick CRG, Biers SM, Arulampalam THA, eds. Essential Surgery: Problems Diagnosis and Management. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 26.
Richmond B. The appendix. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 51.
Rosenthal MD, Sarosi GS. Appendicitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 120.
Last reviewed on: 2/28/2022
Reviewed by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.