top of page

To Open or Not: How the State of Your Appendix Determines How it's Removed During Surgery


Depending on when you were born, you might remember watching movies where they bring a kid into the emergency room with unbearable stomach pains.


With the air thick with anxiety, they're soon admitted to the hospital and taken to surgery. However, time passes, and the kid eventually recovers enough to show off their stitches to friends and family. And there's a look of pride on their face as they retell the story of having something that many people might be familiar with:


Appendicitis.


But surgical methods have improved over the years, and aside from a few specific instances, there are more options available for how to remove the appendix from the body. However, there are a few things we need to review before we discuss those options, starting with:

 

What is the Appendix?

 

The appendix is a tube-like extension from your large intestine that acts as part of your immune system before it develops.

 

What is Appendicitis?

 

The marvel of medical terminology is that there's a clever naming system involved, and 'itis' is often used to describe the 'swelling' of something.


Appendicitis is, simply, the swelling of the appendix, but how it happens can vary. Most commonly, some kind of blockage to the appendix can cause appendicitis, and the combination of a loss of circulation and accumulation of your intestinal bacteria can lead to infection.


This 'blockage' can range from mucus, to stool, to even parasites.


Appendicitis is a medical emergency, and it's important to seek your healthcare provider as soon as possible.

 

What are the Signs and Symptoms?

 

The most common signs and symptoms for appendicitis are:

 

  • Fever and chills

  • Lower right abdominal pain that's relieved when applying pressure

  • Upset stomach and vomiting

  • Swelling of the abdomen

 

Of course, those are only a few of the signs and symptoms, and many other abdominal issues share the same symptoms. Therefore, seeking your healthcare provider is important, because they have resources available to help narrow your diagnosis.

 

How is Appendicitis Diagnosed?

 

Your healthcare provider has a few options they can use to diagnose you for appendicitis, but the main diagnosis tests are:


  • Blood tests: this is to check for white blood cell count (WBCs), which can be a sign of infection.

  • CT scan: this is to take images of your abdomen to check for enlargement or rupture.

  • Ultrasound: this is to check for blood circulation and whether there's some kind of blockage.


How is Appendicitis Treated?

 

Like your tonsils, you can live without your appendix, but unlike your tonsils, the treatment for appendicitis is more straightforward.


Once your health provider confirms that you have appendicitis, the next option is surgical removal of the appendix, which is called an appendectomy. However, the type of surgical procedure chosen will depend on the state of your appendix during your healthcare provider's diagnosis.

 

If Your Appendix Bursts

 

When the appendix bursts, the risk of systemic (or whole body) infection increases exponentially, and emergency surgery will need to be performed.


Meanwhile, other risk factors include abdominal inflammation because of infection (peritonitis), and the collection of pus in spaces in the abdomen (abscess).


Under those circumstances, the more likely surgical option will be the traditional method, called an open appendectomy, which involves the surgeon making an incision on the lower right-hand side of your abdomen to remove the appendix.


Afterward, they'll place a drain inside the incision to drain the bacterial fluids from your body.

 

If Your Appendix Doesn't Burst

 

If your appendix doesn't burst, the more likely surgical option will be a laparoscopic appendectomy.


Laparoscopy means that your surgeon will make several small incisions made to insert a laparoscope, or a camera, into your body. Afterward, our surgeon will use the laparoscope and the other incisions to maneuver and navigate their surgical tools inside you to remove your appendix.


Compared to an open appendectomy, the incisions are much smaller and will recover quicker. Meanwhile, unlike when your appendix ruptures, your surgeon might delay surgery.


According to the World Society of Emergency Surgery, if your appendix hasn't ruptured, then delaying surgery for up to 24 hours for adults won't increase the risk of complications.

 

What are the Risks of Surgery?


Regardless of whether your appendix has burst, there's always a risk of infection with creating incisions, but the likelihood is higher with a rupture. The risk of internal bleeding is also common for both procedures, and so it's advised to take recovery time seriously and to not overextend yourself.


What to Expect After Surgery?

 

Regardless of the type of surgery your surgeon performs, the procedure will require you to stay in the hospital for at least a few days.


While there are a lot of factors to consider since everyone's bodies are different, there's no denying that the difference in recovery can and will depend on whether the appendix bursts.

When it hasn't burst, it's likely that hospital recovery will only take a few days, but recovery time increases when it has burst.


Your healthcare provider will also likely prescribe you antibiotics to treat the risk of infection.


Mobility is important for recovery, and it's likely that your healthcare provider will encourage you to get out of bed and move within a day of surgery.


Make sure to attend any follow-up appointments scheduled, and make sure to reach out to your healthcare provider if you're experiencing any post-surgical complications such as fever and chills, redness and swelling from the incision site, or no bowel movements for more than two days.

 

Conclusion

 

It's amazing to see that, even today, the surgical methods we relied on in the past are still relevant, and there may even be a point where appendectomies won't be necessary to treat appendicitis.


But for now, the options we have are effective, though with technological advances, there might be new surgical methods that will become part of the norm.

 

Sources

 

Healthline. What You Need to Know About Appendectomy. https://www.healthline.com/health/appendectomy

 

 

 

 

World Journal of Emergency Surgery. Diagnosis and treatment of acute appendicitis: 2020 update of WSES Jerusalem guidelines. https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00306-3 Assessed and Endorsed by the MedReport Medical Review Board


Comments


bottom of page