Treatment - Appendicitis

If you have appendicitis, you usually need to have your appendix taken out as soon as possible. This is to avoid the risk of it bursting. This surgery is called an appendectomy or appendicectomy.

The appendix does not perform any important function. Removing it does not cause any long-term problems.

Removing your appendix (appendectomy)

The surgeon removes your appendix under general anaesthetic (when you're asleep).

Types of surgery are:

• keyhole surgery (laparoscopy)
• open surgery

Keyhole surgery (laparoscopy)

Keyhole surgery is usually preferred for removing the appendix. The recovery can be quicker than with open surgery.

The surgeon makes 3 or 4 small cuts (incisions) in your tummy.

They insert special instruments, including:

• a tube with gas that inflates your tummy
• a small tube that has a light source and a camera (laparoscope)
• small surgical tools used to remove your appendix

The surgeon removes your appendix and closes the cuts with dissolvable stitches.

Keyhole surgery

Open surgery

Your surgeon may recommend open surgery if:

• your appendix has already burst and formed a lump called an appendix mass
• you had open abdominal surgery before

To remove your appendix the surgeon makes a larger cut in the lower right side of your tummy.

After surgery, the hospital sends your appendix to a lab to:

• check for inflammation
• rule out other conditions (it's rare to find a serious problem)

After removing your appendix

For the first few days after your surgery you may have:

• some pain and bruising
• constipation for a short time

The pain and bruising will improve over time. You may need to take painkillers for a while.

You should:

• take paracetamol or ibuprofen
• eat plenty of fibre
• drink plenty of fluids

Your GP can prescribe medicine if your constipation does not improve.

Before leaving hospital, a member of staff will tell you what activities to avoid. In most cases, you can return to normal activities in a couple of weeks.

They will also tell you how to look after your wound.

If you had keyhole surgery

If you had keyhole surgery, you may be able to leave the hospital a few days after your surgery.

You may have pain in the tip of your shoulder after the surgery. This is because gas was pumped into your tummy during your surgery.

If you had open surgery

If you had a complicated or open surgery, it may take up to a week before you're well enough to go home.

You may need to avoid high-effort activities for 4 to 6 weeks after your surgery.

Risks of removing your appendix

Surgery to remove your appendix is one of the most common surgeries in Ireland. Serious or long-term complications are rare.

But, like all types of surgery, there are some risks.

These risks are higher if your appendix burst.

Complications include:

• infection of your wound - you might get antibiotics to reduce your risk of serious infections
• bleeding under your skin that causes a firm swelling (haematoma) - this usually gets better on its own, but go to a GP if you're concerned
• scarring
• a collection of pus (abscess)
• a hernia
• an allergic reaction to general anaesthetic (when you're asleep)
• inhaling contents from your tummy - this could lead to pneumonia

But serious complications like this are very rare.

Informed consent

The consent process happens before your surgery. Your doctor will explain your surgery and the possible risks of complications. Ask them any questions you have.

Only give your consent when you feel you have all the information you need to make an informed decision.

Alternatives to emergency surgery

In some cases, appendicitis can lead to a lump forming on your appendix. This is called an appendix mass.

This lump happens when your body tries to deal with the problem and heal itself. It contains your appendix and fatty tissue.

If your doctor finds an appendix mass, they may prescribe antibiotics for a few weeks. You have the surgery after you finish the course of antibiotics.