|SSM Cardinal Glennon Children's Medical Center|
Appendectomy is the surgical removal of the appendix when an infection has made it inflamed and swollen. This infection, called appendicitis, is considered an emergency because it can be life threatening if untreated — occasionally, an inflamed appendix bursts after a day of symptoms. So it's very important to have it removed as soon as possible.
Fortunately, appendectomy is a common procedure and complications are rare. And if appendicitis is promptly diagnosed and an appendectomy is performed, most kids recover quickly and with little difficulty.
Located in the abdomen, the appendix is a small organ that isn't important to a person's health. One end of the appendix is closed and the other opens into the large intestine, the organ that absorbs water from waste (or stool) and moves it out of the body through the anus.
Doctors aren’t always exactly sure what causes appendicitis. Because the appendix is so close to the large intestine, it can become clogged with stool and bacteria. Other times, mucus produced by the appendix can thicken and cause a blockage. In both cases, once the opening to the appendix is congested, it can become inflamed and swollen. Bacteria inside the appendix can multiply and cause appendicitis.
Signs and Symptoms
Appendicitis can cause sudden pain in the middle of the abdomen, usually concentrated around the bellybutton. The pain often moves to the lower right part of the abdomen. At first, pain might come and go, then become persistent and sharp.
Appendicitis also can cause:
If the appendix bursts, a child can develop a high fever, and pain will move throughout the abdominal area.
A child who needs an appendectomy will be admitted to the hospital. The surgeon will describe the procedure and answer your questions. Ask the surgeon to explain anything about the procedure that you don't understand.
An anesthesiologist or a certified registered nurse anesthetist (CRNA) will come in to talk to you about the type of anesthesia to be used.
The surgical team will determine and discuss with you which of these two common surgical types of appendectomy is appropriate for your child:
Sometimes appendectomy is done using a combination of procedure types. In rare cases, a surgeon might start with the laparoscopic procedure but change to an open procedure during surgery. This can happen because the surgeon has trouble finding the appendix with the laparoscope or previous surgeries might have left the patient with abdominal scar tissue that makes it difficult to remove the appendix through laparoscopy.
If this happens, the surgeon will either close up the small incisions and immediately begin the open appendectomy or end the surgery and reschedule the appendectomy.
After the surgery, your child will be taken to a recovery room, which is sometimes called the "post-op" (post-operative) room or PACU (post-anesthesia care unit).
It usually takes about an hour for a child to completely wake up from the anesthesia. People react to anesthesia in a variety of ways, and while most feel fine afterwards, it's possible your child may feel groggy, confused, chilly, nauseated, scared, alarmed, or even sad when waking up.
Also, your child might feel some pain near the incision site, but medication can help lessen it so be sure to let doctors or nurses know if your child is uncomfortable or in pain.
Caring for Your Child
Typically, a child stays in the hospital for 2 to 3 days after an appendectomy, a little longer if the appendix burst before it was removed. Many hospitals allow at least one parent to stay with the child throughout the day and overnight.
When your child is discharged from the hospital, you'll get instructions on home care and when to come back for a follow-up visit with the doctor (usually within a few weeks).
Other things to think about as your child recovers at home:
With a little rest and care, most kids recover from appendicitis and an appendectomy with little difficulty.
When your child is having any kind of procedure or surgery, it's understandable to be a little uneasy. But it helps to know that appendectomies are common procedures and complications are rare. However, as with most procedures, there are some risks, which your doctor will review with you. If you have any other questions or concerns, speak with your doctor.
Reviewed by: Elana Pearl Ben-Joseph, MD