Appendicitis

The appendix is a small, blind-ended tube connected to the colon on the lower right quadrant of the abdomen. It has the shape of a long finger. Normally, people do not feel their appendix. However, if inflamed, the appendix causes acute abdominal pain in the lower right quadrant. The inflammation is the result of food and stool remnants which block the inner area of the appendix. The food and stool remnants also feed bacteria.

Why do we need to remove an infected appendix?
An appendectomy in the early stages of appendicitis will prevent the spread of bacteria into the abdominal cavity. A more advanced case of appendicitis can lead to a ‘burst appendix’, where the appendix ruptures and can cause peritonitis, a severe infection of the peritoneum and possibly death. Operating to treat peritonitis is complex and requires surgeons to wash out stomach contents, in addition to an antibiotic treatment.

What happens if appendicitis isn’t diagnosed in its early stages?
Even the most experienced doctors in the world have difficulty diagnosing the disease in its early stages. Symptoms include sharp pain in the lower right quadrant of the abdomen, fever, vomiting, and a rise in the white blood cell count. However, these symptoms are not necessarily the same for everyone just like the fact that not everyone has the same appendix shape or even location. This presents a problem for the surgeon – not everyone has the same symptoms, and he fears he may have missed something, but on the other hand, he shouldn’t operate on every child who presents with symptoms of fever and stomach pains. The most common way to evaluate a possible appendectomy is to monitor the child and compare clinical results. In some cases doctors will use CT scans or ultrasounds to see if the appendix is inflamed.

Prior to the operation, you will meet with the anesthesiologist and a nurse, who will explain the surgery. You and your child can choose which way you would like the anesthesia to be administered. The anesthesiologist will explain to your child that he won’t feel a thing during surgery, he won’t wake up during the surgery and he will be there with your child during the surgery itself. One parent will be able to accompany the child into surgery.

The appendectomy usually requires a small incision in the abdomen. In the event that the appendix ruptured, the surgeons will enlarge the cut to wash out the pus that has entered the abdominal cavity. In some cases, the doctor will not suture the incision completely in order to allow more pus to drain out. After the surgery, the child will be brought to a recovery room with one of his parents. He will be hooked up to an IV and his incision will be bandaged (covering the stitches). Your child may experience some dull pain in the area of the surgery. Pain relief medications will be available. The doctor will tell you how long your child will remain in the hospital. Once you return home, your child can return to school but should avoid physical activities for a few weeks.

How will my child's life be influenced by not having an appendix?
The appendix plays an important role for animals, but its role in the human body is still unknown. Therefore, an appendectomy will not affect your child’s day-to-day activities.