Appendectomy

What is acute appendicitis?

Acute appendicitis is an infection of the appendix that makes it inflamed. The appendix is located in the right lower abdomen and is a “worm-like” tubular structure attached to the first part of the large intestine.

What are the symptoms of appendicitis?

Appendicitis usually starts at the belly button and later localizes in the right lower quadrant of the abdomen. The symptoms include:
  • Nausea
  • Vomiting
  • Fever

How is it treated?

Surgery for appendicitis is usually done laparoscopically, however sometimes, a more traditional small right lower abdomen incision is necessary.

What will happen in the hospital?

Your child may have an ultrasound and a complete blood count (CBC) drawn to establish if he or she does have appendicitis. Sometimes a CT scan may be necessary, or even a repeat ultrasound to confirm the diagnosis. Once the diagnosis is confirmed, your child will receive IV antibiotics. While in the OR, your child will have general anesthesia. After surgery, your child will discharged from the recovery room or sent to the pediatric surgical unit for more monitoring. No further antibiotics will be given after surgery if there is no sign of perforated appendicitis at the time of surgery.

Details of surgical procedures:

Laparoscopic appendectomy:
  • 2 or 3 small incisions (less than 1 inch) to the lower abdomen 
  • A small camera is inserted through one of the incisions, usually through the belly button 
  • Air is put through one of the tubes to inflate the abdomen 
  • The other 2 incisions are used to locate and remove the appendix 
  • Once removed, the incisions are closed with dissolvable sutures 
  • Steri strips are placed over the incisions and left in place

Open appendectomy:
  • One small incision (usually 1-2 inches) to the right lower abdomen 
  • Appendix is located and removed 
  • After removal the surgical incision is stitched together and dressed as above

When will my child be discharged?

After surgery, your child will be sent to the recovery room. He or she will be given medications to control pain and will be started on a clear liquid diet. If pain is controlled and your child is taking good intake by mouth, he or she may be able to go home from the recovery room. If your child is not able to tolerate clear liquids and needs better pain control, he or she will be sent to the pediatric surgical unit and admitted. Discharge will either be later that day or the next day.

What will be my child's recovery?

Children with acute appendicitis can go back to school within 3-4 days after discharge. Gym and sports may be resumed in 2 weeks. No tub bathing or swimming for 10 days. It is ok to shower and let water run over the steri strips that have been placed over the surgical sites. Your child will go home with medications to manage pain.

We will plan to see your child 2-3 weeks after discharge in our clinic for follow up or you will receive a phone follow up from one of the Pediatric Surgical APRN’s.

What should I be looking out

  • Fevers
  • Abdominal pain 
  • Nausea/vomiting
  • Diarrhea
  • Wound infections (redness, swelling, drainage, tenderness)
  • Steri strips placed over the surgical sites will fall off on their own in approximately 7-10 days. If at that point they have not, it is ok to peel them off like you would a band aid.