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. It is not always known what causes appendicitis but the obstruction of the appendix e.g: 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.
Other symptoms that may be experienced include:
- Loss of appetite
- Constipation or diarrhoea
- Low grade fever
- Pain on pressing the abdomen.
Tests undertaken to assist with diagnosis may include:
- Urine tests (to rule out urine infection)
- Blood tests - an increased white blood cell count can indicate the presence of infection.
- Abdominal x-ray
- Abdominal ultrasound scan
- CT Scan
Complications of appendicitis
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.
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 "keyhole" surgical technique involves making three 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 taken orally as liquid or tablets, or intravenously through a drip in the hand or arm (especially if the appendix has ruptured or peritonitis has developed).
Most people are able to be discharged home 1-4 days after their appendix has been removed but a longer hospital stay may be required if the appendix has ruptured or peritonitis has developed. 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.
Helwick, C. A. (2006) Appendicitis. Gale Encyclopaedia of Medicine. Third Edition. Jacqueline L. Longe, Editor. Farmington Mills, MI. Thompson Gale.
Kidshealth (2013) Appendicitis. The Paediatric Society of New Zealand and Starship Foundatiohn. www.kidshealth.org.nz/appendicitis
Last Reviewed – 19 April 2013