Surgery Information

Appendicitis

The appendix is a small portion of the intestine located where the small and large intestines meet at the cecum. Appendicitis occurs when the opening to the appendix becomes blocked by a fecolith (stool ball) or other matter. Common symptoms of appendicitis include pain in the right lower abdomen, nausea, vomiting, and anorexia (decreased appetite). This pain often follows general abdominal pain that may at first resemble cramps or constipation.

Diagnosis of appendicitis

Many people are seen in their primary care doctor’s office or in the emergency room. Diagnosis is made by the history (symptoms and description of the illness), abdominal exam, labwork, and sometimes a CT scan (specialized x-ray).

Treatment of appendicitis

Appendicitis is treated by surgery known as an appendectomy (removal of the appendix).
Most of the time, this procedure can be done laparoscopically. For a laparoscopic appendectomy, three small incisions are made and the appendix is removed with the aid of a camera known as a laparoscope. If the appendix has ruptured, the patient may require a drain that will prevent pus from collecting inside the abdomen after the surgery. The patient may have to stay in the hospital for several days on antibiotics. If the appendix has not ruptured, the patient can often resume diet and go home the following day.

Post-Operative Instructions

1. Diet can be resumed as tolerated.
2. Constipation is a common problem following this operation. Milk of Magnesia which is available over-the-counter can be helpful in managing your constipation.
3. No heavy lifting for two weeks. Other activities may be resumed as tolerated.
4. Expect to need at least a few days off from school or work. Some people may need as long as 2 weeks.
5. Driving is not permitted as long as narcotic pain medication is being taken (Vicodin) or pain is severe enough that a patient cannot step on the accelerator or brake effectively in an emergency. Driving is not recommended for several days after surgery.
6. Incisions will have an outer dressing as well as an inner dressing. The outer dressing may be removed the day after surgery and the patient may shower normally at this time. The patient will also have inner dressings that resemble bandaids known as steri-strips. These should be left in place. They will fall off on their own.
7. Sutures are usually located underneath the skin and do not require removal. Occasionally, a patient will notice a small thread or knot. This will dissolve on its own or can be removed in the office.
8. Fevers, redness or drainage from the incisions, and severe pain are signs that you may need to call the office. Please feel free to call for other problems as well.
9. Follow-up should be scheduled 2 weeks from the date of surgery. If you have a drain, make a follow-up appointment in one week.
10. Drainage should be measured every 24 hours and the amount recorded on a piece of paper. If the drainage should suddenly stop or change color, please call the office.