Professional Documents
Culture Documents
Appendectomy
Surgical Removal
of the Appendix
Patient Education
This educational information is to
help you be better informed about
your operation and empower you
with the skills and knowledge needed
to actively participate in your care.
Small intestine
Keeping You Large intestine
Appendix
Informed
Information that will help you The Condition Benefits and Risks
further understand your operation Appendectomy is the surgical removal An appendectomy will remove the infected
and your role in healing. of the appendix. The operation is done organ and relieve pain. Once the appendix is
to remove an infected appendix. An removed, appendicitis will not happen again.
Education is provided on: The risk of not having surgery is the appendix
infected appendix, called appendicitis,
Appendectomy Overview .....................1 can burst and release bacteria can burst, resulting in an abdominal infection
and stool into the abdomen. called peritonitis.
Condition, Symptoms, Tests..................2
Treatment Options....................................3 Possible complications include abscess,
What are the common symptoms? infection of the wound or abdomen,
Risks and Possible Complications .......4 intestinal blockage, hernia at the incision,
Abdominal pain that starts
Preparation and Expectations ..............5 around the navel pneumonia, risk of premature delivery
Not wanting to eat (if you are pregnant), and death.
Your Recovery and Discharge...............6
Pain Control .................................................7 Low fever
Glossary/References.................................8
Nausea and sometimes vomiting Expectations
Diarrhea or constipation Before your operation—Evaluation
usually includes blood work, urinalysis,
and an abdominal CT scan, or abdominal
Treatment Options ultrasound. Your surgeon and anesthesia
Surgery provider will review your health history,
medications, and options for pain control.
Laparoscopic appendectomy—The
appendix is removed with instruments The day of your operation—You will not be
placed into small abdominal incisions. allowed to eat or drink while you are being
evaluated for an emergency appendectomy.
Open appendectomy—The appendix
is removed through an incision Your recovery—If you have no complications,
in the lower right abdomen. you usually can go home in 1 or 2 days after a
laparoscopic or open procedure.
Nonsurgical
Call your surgeon if you are in severe pain,
Surgery is the standard treatment have stomach cramping, a high fever, odor
for an acute (sudden) infection of or increased drainage from your incision, or
the appendix. Antibiotic treatment no bowel movements for 3 days.
might be used as an alternative for
1,2
This first page is an overview. For more detailed information, review the entire document.
Appendix stapled
Nonsurgical Treatment
If you only have some of the signs of
appendicitis, your surgeon may treat you with
Removal of appendix
antibiotics and watch for improvement. In an
uncomplicated appendectomy, antibiotics
of reoccurrence.1-2,5
Removal of appendix
3
Appendectomy
R isks of This Pro cedure
Your surgeon will do everything possible to minimize risks, but appendectomy, like all operations, has risks.
Risks of This Procedure from Outcomes
Percentage Keeping You Informed
Reported in the Last 10 years of Literature
Pregnancy risks Premature labor The risk of fetal loss increases to 10% when the appendix ruptures
8 to 10% and there is peritonitis (infection of the abdominal cavity).6
Fetal loss 2%
Pediatric risks Less than 1% for Children with perforated appendix have increased wound
all complications infection rates and abdominal infections. There are no deaths
reported with simple appendectomy.
Wound Infection: Infection at the Laparoscopic 1.9% Antibiotics are typically given before the operation. Smoking can
area of the incision or near the organ Open 4.3% increase the risk of infection.
where the surgery was performed
Pneumonia: Infection in the lungs Less than 1% Stopping smoking, walking and deep breathing after your
operation can help prevent lung infections.
Urinary tract infection: Infection Less than 1% A urinary catheter (small thin tube) that drains urine from the
of the bladder or kidneys bladder is sometimes inserted. Signs of a urinary tract infection
include pain with urination, fever, and cloudy urine.
Blood clot: A clot in the legs Less than 1% Longer surgery and bed rest increase the risk. Getting up,
that can travel to the lung walking 5 to 6 times per day, and wearing support stockings
reduce the risk.
Heart complication: Includes heart Less than 1% Problems with your heart or lungs can be sometimes be
attack or sudden stopping of the heart worsened by general anesthesia. Your anesthesia provider will
take your history and suggest the best option for you.
Any complication, including: Surgical Laparoscopic 3.4% Complications are higher in smokers, obese patients, and
Open 6.4% those with other diseases such as diabetes, heart failure,
clots, renal (kidney) complications, cardiac renal failure and lung disease. Wound healing may also be
complications, and return to the operating room decreased in smokers.
*The ACS Surgical Risk Calculator estimates the risk of an unfavorable outcome. Data is from a large number of patients who
had a surgical procedure similar to this one. If you are healthy with no health problems, your risks may be below average.
If you smoke, are obese, or have other health conditions, then your risk may be higher. This information is not intended
to replace the advice of a doctor or health care provider. To check your risks, go to the ACS Risk Calculator at
http://riskcalculator.facs.org/online.
for Yo ur O p e ration
5
Appendectomy
Your Recove r y and D ischarge
Your Recovery
Keeping You
and Discharge
Informed
Thinking Clearly
High-Fiber Foods
Handwashing Steri-Strips
for 1 or 2 days. Do not drive, drink alcohol, or
bran cereals and whole-grain make any big decisions for at least 2 days. Follow your surgeon’s instructions on when
to change your bandages.
apricots, and dates), raspberries, Nutrition
A small amount of drainage from the
blackberries, strawberries, When you wake up, you will be able to drink incision is normal. If the drainage is thick
sweet corn, broccoli, baked small amounts of liquid. If you do not feel and yellow or the site is red, you may have
potatoes with skin, plums, pears, sick, you can begin eating regular foods. an infection, so call your surgeon.
apples, greens, and nuts.
If you have a drain in one of your incisions, it
8 to 10 glasses per day. will be taken out when the drainage stops.
When to Contact
Non-Medicine Pain Control Keeping You
Distraction helps you focus on other
Your Surgeon activities instead of your pain. Music, Informed
If you have: games, and other engaging activities are Extreme pain puts extra stress
especially helpful with children in mild pain. on your body at a time when
Pain that will not go away your body needs to focus on
Splinting your stomach by placing
Pain that gets worse a pillow over your abdomen with healing. Do not wait until your
pain has reached a level “10”
A fever of more than 101°F (38.3ºC) or is unbearable before telling
movement can help reduce the pain.
Repeated vomiting your doctor or nurse. It is much
Guided imagery helps you direct and easier to control pain before it
Swelling, redness, bleeding, or bad- control your emotions. Close your eyes becomes severe.
smelling drainage from your wound site and gently inhale and exhale. Picture
Strong abdominal pain yourself in the center of somewhere Laparoscopic Pain
beautiful. Feel the beauty surrounding Following a laparoscopic
No bowel movement or unable you and your emotions coming back to procedure, pain is sometimes
to pass gas for 3 days your control. You should feel calmer. felt in the shoulder. This is
Watery diarrhea lasting longer than 3 days due to the gas inserted into
your abdomen during the
OTHER INSTRUCTIONS:
procedure. Moving and walking
Pain Control helps to decrease the gas and
the right shoulder pain.
Guided imagery
use. Examples of NSAIDs include ibuprofen,
Mortrin, Aleve, and Toradol (given as a shot).
7
G lossar y of Terms and Appendectomy
M ore I n formation
For more information, please go to the American College of Surgeons Patient Education Web site at www.facs.org/patienteducation.
For a complete review of appendectomy, consult Selected Readings in General Surgery, “Pediatric Appendectomy” 2014 Vol. 40 No. 4 and
“Adult Appendectomy” 2011 Vol. 38 No. 5 at www.facs.org/SRGS.
GLOSSARY REFERENCES
Abdominal ultrasound: Sound waves are used The information provided is chosen from clinical research. The research
to determine the location of deep structures below does not represent all of the information available about your
in the body. A hand roller is placed on top of operation.
clear gel and rolled across the abdomen.
1. Wilms IM, de Hoog DE, de Visser DC, et al. Appendectomy versus
Abscess: Localized collection of pus. antibiotic treatment for acute appendicitis. Cochrane Database Syst Rev.
2011;11:CD008359.
Advance directives: Documents signed by a competent
person giving direction to health care providers 2. Kao LS, Boone D, Mason RJ; Evidence-based reviews in surgery.
about treatment choices. They give you the chance Antibiotics vs appendectomy for uncomplicated acute appendicitis. J
to tell your feelings about health care decisions. Am Coll Surg. 2013;216(3):501-505.
3. Cheng HT, Wang YC, Lo HC, et al. Laparoscopic appendectomy versus
Adhesion:
open appendectomy in pregnancy: a population-based analysis of
internal organs to adhere or stick together.
maternal outcomes. Surgical Endoscopy. Aug 30, 2014; epub ahead of
Complete blood count (CBC): A blood test that print.
measures red blood cells (RBCs) and white blood 4. Stewart D. The management of acute appendicitis. In JL Cameron & AM
Cameron (Eds), Current Surgical Therapy (11th Ed.). 2014:252-254.
The normal range for WBCs is 8,000 to 12,000. Philadelphia: Elsevier Saunders.
Computed tomography (CT) scan: A specialized X ray 5. Di Saverio S, Sibilio A, et al. The NOTA Study (Non operative treatment
and computer that show a detailed, 3-D picture of your f
abdomen. A CT scan normally takes about 1½ to 2 hours. of antibiotics (amoxicillin and clavulanic acid) for treating patients with
Electrocardiogram (ECG): Measures the rate right lower quadrant abdominal pain and long-term follow-up of
and regularity of heartbeats, the size of the heart conservatively treated suspected appendicitis. Annals of Surgery. 2014;
chambers, and any damage to the heart. 260:109-117.
6. Li X, Zhang J, et al. Laparoscopic versus conventional appendectomy
Nasogastric tube: A soft plastic tube inserted
—a meta-analysis of randomized controlled trials. BMC Gastroenterology.
in the nose and down to the stomach.
2010;10:129. Available online www.ncbi.nlm.nih.gov/pmc/articles/
Urinalysis: A visual and chemical examination PMC2988072.
of the urine, most often used to screen for 7. Peled Y, Hiersch L, Khalpari O, et al. Appendectomy during pregnancy—
urinary tract infections and kidney disease. is pregnancy outcome dependent on operator technique? Journal of
Maternal-Fetal & Neonatal Medicine. 2014;27:365-367.
DISCLAIMER
procedures. It is not intended to take the place of a discussion with a