The appendix is a small, finger shaped outpouching from the colon, also known as the large intestine. It is about 3-4 inches long and located in the bottom right quarter of the abdomen, just above the groin area.
About one in every 20 Americans will have their appendix surgically removed at some point in their lives. It is most common in those between the ages of 10 and 30. Despite the fact that we do not have a full understanding of the use or anatomical value of the appendix, it causes quite a bit of pain and discomfort to a wide swath of people.
Appendicitis is the medical term for inflammation of the appendix. This can happen for a number of reasons that cause blockage in the appendix. Most often, infection, fecal matter, a foreign body or a tumor will cause blockage and resultant problems.
The symptoms of appendicitis can begin as rather mild. These may include generalized malaise, low fever, pain around the bellybutton and difficulty passing gas. These progress to the telltale sign of appendicitis – pain when pressure is placed and then removed on lower right quadrant of the abdomen. The nature of appendicitis lends itself to deteriorate very rapidly. Soon, patients can experience a high-grade fever, significant pain in the abdomen, even nausea, cramps and vomiting
Because of the rapid onset of symptoms, appendicitis is an urgent situation requiring an immediate call to your doctor or visit to the ER.
Eventually, untreated appendicitis may cause the appendix to burst. This is a worst-case scenario that allows fecal matter to enter the abdominal cavity which, in turn, may causes a serious infection in the abdomen known as peritonitis. If the appendix bursts, it becomes a life-threatening situation and treatment is far more difficult.
The definitive way to treat appendicitis is by removing the appendix in a procedure known as an appendectomy. Virtually all uncomplicated appendectomies are performed laparoscopically using a few small incisions in the lower right quadrant of the abdomen. The appendix is carefully removed from the rest of the colon and pulled out of the abdomen through the largest of the incisions, in a specially made surgical bag. If the appendix has burst, if there is widespread infection or if there is an abscess, open surgery will be necessary to clean out the abdomen.
The appendectomy takes approximately 45 minutes under general anesthesia or longer if there is a perforation. Patients will remain in the hospital for one to two days in most cases, but longer if there is a serious infection.
The risks of an appendectomy are very similar to the inherent risks of any major surgical procedure in the abdomen. However, the delicate nature of an infected appendix means there is a higher likelihood of perforation during surgery. Your surgeon will discuss the most common risks with you during consultation.
Recovery from appendicitis requires about 2 to 3 weeks from open surgery and about 1 to 2 weeks for laparoscopic surgery. Patients will visit with their surgeon between 10 days and two weeks after the procedure.
The prognosis is for a non-complicated appendectomy is very good. Complications such as a perforated appendix or severe infection will alter the prognosis depending on how well the infection can be controlled.