Appendectomy

What is appendicitis?

Appendicitis (say: a-pen-da-SIE-tis) is an inflammation or swelling of the appendix (say: a-PEN-diks). The appendix is a small, tube-like structure attached to the first part of the large intestine, called the colon. It is in the lower right side of your child's abdomen (belly). It has no known use in the body.

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Appendicitis occurs when the appendix becomes blocked and inflamed.

Appendicitis happens when the appendix becomes blocked. The blockage causes the appendix to swell. The swelling can cause pain, diarrhea, vomiting (throwing up), and fever.

If the doctor thinks your child might have appendicitis, she will do a physical exam. She may also order an ultrasound or computed tomography (CT) scan.

What is an appendectomy?

If your child has appendicitis, it usually means your child will need surgery (an operation) to take out the appendix. This operation is called an appendectomy (say: a-pen-DECK-ta-mee). It is a common, simple procedure. This surgery normally will not affect your child's growth. Your child will still be able to digest foods.

An appendectomy may be either an emergency surgery or a planned surgery, depending on your child's condition. Your child's doctor will decide if your child needs to stay in the hospital or can come to the hospital on the day of the surgery.

During the appendectomy

Your child will have a special "sleep medicine" called a general anaesthetic. This helps make sure your child sleeps through the operation and does not feel any pain. 

The surgeon will make incisions (cuts) in your child's abdomen. The surgeon may also use a camera called a laparoscope and make small cuts. The surgeon will cut out your child's appendix and sew up the bowel where it was attached. Then the surgeon will close the incisions using small pieces of tape called steri-strips.

An appendectomy takes about 1 hour.

After the appendectomy

After the appendectomy, your child will go to the Post-Anaesthesia Care Unit, also called the PACU or recovery room. He will stay there for about 1 hour. You may visit your child once he wakes up. Your child will then go back to the inpatient unit. He will stay there for about 12 to 24 hours. 

Your child can go home when:

  • His heart rate, breathing, blood pressure, and temperature are normal.
  • He is able to eat without vomiting (throwing up).
  • He is comfortable taking oral pain medicine. Oral medicine is medicine taken by the mouth.  

Taking care of your child at home

Care of the incision

The incisions from the surgery will be covered by a dressing called steri-strips. You do not need to do anything to the strips. Wash your hands before touching or cleaning the incision area. 

A small amount of blood on the strips is common. If the blood seems fresh or if the amount of blood increases, press on the area with a clean washcloth for 5 to 6 minutes. Then call your child's surgeon's office.

If the bleeding does not stop, take your child to a family doctor or to the emergency department.

The steri-strips will fall off on their own. You can remove the strips if they have not fallen off 7 to 10 days after your child's surgery.

Activities

Your child can go back to normal activities once he feels able. 

Diet

Your child should be able to return to his normal diet after the surgery. If your child has problems eating, call your surgeon's office. 

Pain medicine

When your child comes home, you may want to give acetaminophen for the first 24 hours after surgery. Follow the instructions on the bottle for the amount of medicine to give to your child. Your child can have pain medicine as needed after the first 24 hours.

Bathing

You can give your child a bath 48 hours after surgery.

School

Your child may go back to day care or school when he feels able and you feel comfortable with him returning to his normal routine. 

When to call the surgery team

The main concern after an appendectomy is an abscess (infection). Call your child's surgeon's office if you notice any of the following signs or symptoms of infection in your child:

  • fever of 38.5°C (101°F) or higher
  • thick yellow or green foul-smelling discharge from the incision area
  • bleeding at the incision area
  • redness at the incision area
  • swelling at the incision area
  • pain that gets worse, even after taking pain medicine
  • less appetite or vomiting (throwing up)
  • stomach pain or distention (swelling or fullness)
  • your child feels lethargic or very tired or drowsy

If you have a question or a concern that is not urgent, call your child's surgeon's office during business hours or leave a message on the answering machine after hours. If you have an urgent concern, take your child to his family doctor, paediatrician, or the nearest emergency department.

My child's surgeon is: 

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My child's regular doctor is:

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Key points

  • If your child has appendicitis, your child will probably need surgery (an operation) to remove the appendix.
  • Depending on your child's condition, the appendectomy may be an emergency operation or a planned operation.
  • Your child will need a general anaesthetic for the operation.
  • Call your child's surgeon's office if your child has a lot of bleeding or you notice signs of infection.

Kimberly Colapinto, RN, BScN, MN

Jacob Langer, MD, FRCSC

9/24/2009

At SickKids:

The General Surgery clinic is located on 5D in the Atrium.

Outpatients should come to ward 6B in the Atrium at least 2 hours before the surgery.





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