The appendix is a small, hollow, finger-like tube that extends from the beginning of the large bowel on the lower right hand side of the abdomen. It has no known useful function. Appendicitis is where the appendix becomes inflamed, swollen and infected.

 

It is not always known what causes appendicitis but the obstruction of the appendix eg: with faeces, is one possible cause. Appendicitis appears to occur less commonly in people who eat foods high in fibre and roughage, such as raw fruit and vegetables.

 

Appendicitis occurs more commonly in males than females and although it can occur at any age, it tends to occur more often in adolescents and young adults (usually between the ages of 10 - 19 years).

 

 

 

The symptoms of appendicitis vary but can include:

 

 

 

Diagnosis is made after thorough assessment of the clinical signs and symptoms. Tests undertaken to assist with diagnosis may include:

 

Appendicitis can sometimes be difficult to diagnose, particularly in infants and theelderly.

 

 

 

It is important to remove an inflamed appendix before it ruptures. The time between the onset of pain and rupture can sometimes be only a matter of hours, especially in small children and infants.

 

If an inflamed appendix does rupture this can cause infection to move into the abdomen and result in peritonitis (an inflammation of the peritoneum, the membrane that covers the abdominal organs).

 

Because urgent treatment is vital but appendicitis is difficult to diagnose, about 15% of all appendixes surgically removed are found to be healthy.

 

 

 

Surgical removal of the appendix (appendectomy) is the treatment of choice for appendicitis. Antibiotics alone are rarely used as a cure.

 

 

The traditional surgical technique for removing an inflamed appendix involves making an incision in the lower right side of the abdomen. The muscle layers are separated and the appendix is located and removed. The muscle layers and skin are then sewn back together using dissolvable stitches.

 

 

This "closed" surgical technique involves making a series of small incisions in the abdomen, and inserting a laparoscope (a fine narrow tube with a small camera at its tip) through one incision and surgical instruments through the other incisions. The laparoscope allows the surgeon to see the inside of the abdominal cavity on a television screen. The abdominal cavity is inflated with carbon dioxide gas to allow the surgeon to clearly see the area. The surgeon uses the laparoscope to locate the appendix and the surgical instruments to remove it.

 

The small incisions in the abdomen are closed using stitches or small paper tapes (steristrips) and are covered by sterile, waterproof dressings.

 

Antibiotics are usually given before and/or during surgery and may also be given after surgery. The antibiotics may be given as tablets or intravenously (through a drip in the hand or arm) if the infection is significant or peritonitis has developed.

 

 

 

Recovery times after surgery will vary according to the severity of the appendicitis and the surgical technique used.  Laparoscopic appendectomy tends to have a faster recovery time.

 

Fluids will be given intravenously until the bowel is working effectively. Oral intake of fluid and food begins gradually and increases as tolerated and/or as recommended by the surgeon.

 

Most people are able to be discharged home 2-5 days after their appendix has been removed. Prior to discharge from hospital the surgeon will give clear guidelines on wound care and follow up, what activity can be undertaken and when a return to school or work can be expected.

 

 

 

Anderson, K.N., Anderson, L.E. & Glanze, W.D. (eds.) (2006) Mosby’s medical, nursing, & allied health dictionary (6th ed.) St. Louis: Mosby-Year Book, Inc.

 

Helwick, C. A. (2006) Appendicitis. Gale Encyclopaedia of Medicine. Third Edition. Jacqueline L. Longe, Editor. Farmington Mills, MI. Thompson Gale.

 

Kids Health (2001) Appendicitis. Nemours Foundation.
http://www.kidshealth.org/parent/infections/stomach/
appendicitis.html

 

Last Reviewed – 10/04/07

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