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Appendectomy

An appendectomy is the surgical removal of the appendix – a small, fingerlike pouch located where the small intestine joins the large intestine. Appendicitis, which causes the appendix to become inflamed and swollen, is a common reason for this procedure. In most cases, appendicitis is caused by a blockage of the opening of the appendix by a piece of stool. It also may be a reaction to an infection in the digestive tract.

Because of the risk of rupture, appendicitis must be treated immediately. If an infected appendix ruptures, the infection may move into the abdomen and cause peritonitis – a dangerous infection of the lining of the belly that can be fatal if not treated right away.

What happens during surgery?

An appendectomy is done under general anesthesia, which means your child will be asleep and will not feel any pain during the surgery. Your child will receive antibiotics both before and after the procedure. There are two kinds of appendectomies: laparoscopic and open surgery. In a laparoscopic procedure, the surgeon makes a tiny incision in the abdomen and inserts a laparoscope – a thin, metal tube with a light and tiny camera. Other small incisions are made to insert surgical tools used during the operation. Through these incisions, the surgeon removes the appendix. An open surgery involves one larger cut in the lower right side of the belly.

A rupture of the appendix before surgery can cause an abscess (infected sore) near the place where the appendix ruptured. If the appendix does rupture, the surgeon may put a drainage tube in the abdomen during surgery to let the infection drain.

What should I expect after surgery?

Most children are awake after their procedure; however, some children may remain sleepy for hours. Some may feel sick to their stomach. Your child will receive fluids and antibiotics through an IV line. If the appendix is not ruptured, a clear liquid diet is started as soon as the child is awake. If there was a rupture or perforation at the time of surgery, your child will be given additional antibiotics. If your child had a ruptured appendix, it may be less than 24 hours or as long as a couple of days before he or she receives anything by mouth. Food or drinks are not given until gas or stool is passed. If your child is able to take clear liquids without nausea or vomiting, he or she will be allowed to eat regular food.

Taking deep breaths and sitting up in bed can help speed the recovery time. Once your child is no longer sleepy, he or she will be encouraged to get up and walk around the room.

Most children are able to go home from the hospital within 24 to 48 hours and are able to go back to school within one week. A child who has had a ruptured appendix is usually in the hospital for four to five days.

How do I care for my child at home?

It’s important that you keep your child’s surgery site clean and dry for at least two days after surgery. Wound dressings will vary for each child. If your child has Steri-StripsTM only, they will fall off on their own. If your child has glue-like covering over the incision, the glue also will come off by itself. If the wound was left open, you will be given instructions on how to change the bandages at home.

Children may begin taking showers two days after surgery, but should not be submerged in bath water for one week. Gym class, contact sports, and climbing games should be avoided for two to four weeks after surgery or until you have followed up with your child’s physician.

When should I call my child’s healthcare provider?

Call your provider if your child’s temperature is over 101° F (38.0° C), he or she vomits excessively or develops diarrhea, has a lot of swelling or bleeding from the incisions. Also call your child’s physician if he or she has an incision that looks infected (red and puffy, with green or yellow drainage), has pain even after taking pain medicine as prescribed or has not voided for 12 hours after surgery.