Surgical Gastroenterology



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Overview


Appendectomy is the surgical removal of the appendix, a small, finger-shaped pouch that is located at the cecum (the junction between the large and small intestines). The surgery is the standard treatment for appendicitis (inflammation and infection of the appendix) and patients usually recover from appendectomy without experiencing complications. A ruptured appendix is considered a medical emergency.

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Causes


There's no way to prevent appendicitis. Because the appendix is so close to the large intestine, it can become clogged with stool and bacteria. Other times mucus produced by the appendix can thicken and cause a blockage. In both cases, once the opening to the appendix is congested, it can become inflamed and swollen, causing appendicitis.


Signs and Symptoms


Appendicitis can cause sudden pain in the middle of the abdomen, usually concentrated around the bellybutton. The pain often moves to the lower right part of the abdomen. At first, pain might come and go, then become persistent and sharp.

Appendicitis also can cause:

  • loss of appetite
  • fever
  • nausea
  • vomiting
  • diarrhea
  • frequent or painful urination

If the appendix bursts, a child can develop a high fever, and pain will move throughout the abdominal area.


The Surgery


A child who needs an appendectomy will be admitted to the hospital. The surgeon will describe the procedure and answer your questions. Ask the surgeon to explain anything about the procedure that you don't understand.
The surgical team will determine and discuss with you which of these two common surgical types of appendectomy is appropriate for your child:

  • Open Appendectomy
    An open appendectomy is the "traditional" way of removing an infected appendix. Basically, a surgeon makes an incision in the abdomen and locates the infected appendix. The appendix is cut away from the large intestine and removed from the body. The incision is then closed with stitches.
  • Laparoscopic Appendectomy
    Laparoscopy is a type of surgery that uses a tiny video camera called a laparoscope to help surgeons see inside the body. The thin tube of the laparoscope is inserted into the body through a small incision and guided to the appendix to act as the surgeon's "eyes." Other small incisions are made so medical instruments can be guided to the area, and the entire operation is done while the surgeon looks at a TV monitor.



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