Are you feeling pain in your
lower right side of the abdomen?

Do you need an appendectomy?

If you have appendicitis, your appendix needs to be removed as soon as possible. Because if it is not treated, it can burst and create a medical emergency. So, make your appointment today and reclaim your health!

Appendix

The most common reason for the removal of the appendix is appendicitis. It is the inflammation of the organ of appendix. The appendix is a finger like tube of the first part of the large intestine which is above the cecum-located at the junction of the small intestine and the large intestine. This finger like projection does not have any apparent function in the human body. It has some role in immunity function as a child, but this role is lost as the person grows up. Appendicitis is a common condition that can affect people of all ages. Laparoscopic appendectomy is considered as the standard treatment of appendicitis.

Causes of Appendicitis in Children and Adolescents:

Appendicitis is often seen in children and adolescents.

Immune Center Enlargement:

In childhood, viral infections can lead to the enlargement of immune centers near the appendix. When these centers swell, they can block the entrance to the appendix.

Blockage Leads to Infection:

When the entrance to the appendix is blocked, it becomes a closed space where bacteria can multiply. This bacterial overgrowth leads to an infection, resulting in inflammation of the appendix, known as appendicitis. This is a common cause of appendicitis in children and adolescents.

Causes of Appendicitis in Adults:

While the mechanism is somewhat similar to that in children, appendicitis in adults can occur due to different reasons:

Blockage by Stool

In adults, a piece of stool, also known as fecalith, can block the entrance to the appendix. This blockage transforms the appendix into a closed compartment, allowing bacteria to thrive, leading to infection and inflammation.

Spontaneous Inflammation

In some cases, the appendix may become inflamed without an apparent blockage. This spontaneous inflammation is less common but can still lead to appendicitis. A laparoscopic appendectomy is widely regarded as the primary or most common approach for treating appendicitis.

Immediate Treatment of Appendicitis is Crucial

Once the appendix is inflamed, there is a risk of rupture due to the

  • Development of high pressure; The inflammation itself causes the appendix to swell and increases pressure within it. The longer this pressure builds, the greater the risk of rupture.
  • Collection of pus and infection within the small compartment of appendix.

The appendix may rupture at any point and the infection can spread into the abdominal cavity, resulting in a condition called peritonitis.

Peritonitis is a medical emergency and can be life-threatening if not treated promptly. This is why it’s crucial to seek immediate medical attention if you experience symptoms of appendicitis, such as severe abdominal pain, nausea, and fever. Early diagnosis and laparoscopic appendectomy of the inflamed appendix are the most effective ways to prevent the rupture of the appendix and its potentially severe consequences.

Location of Appendix Pain

When the appendix gets inflamed, the initial representation is usually a pain around the belly button which gradually shifts to the right lower part of abdomen. Such may also occur in other areas if the appendix is not in the typical location. For instance, in some people, the appendix may be located in the pelvic area, in which case the pain may arise in the area above the urinary bladder. And in some people, the appendix may be located behind the large intestine called a retrocecal location, which can cause pain in the lower back on the right side, which mimics the pain of kidney stones.

Other conditions that may have a similar presentation of pain includes;

  • Pain of kidney stones
  • Pain from inflammation of the lymph nodes in that area that can occur in young children due to any kind of viral infections
  • Menstrual cycle pain in women

That is why it is important to get a proper check up from a physician who can evaluate the condition thoroughly and advise the best course of action. And when the appendicitis is confirmed, a laparoscopic appendectomy is often the go-to surgical approach for treating it.

Diagnosis  

Following tests can be performed to establish the diagnosis;

Ultrasound of the abdomen

CT scan of the abdomen

Treatment

Once the diagnosis is established, the standard treatment for appendicitis is to have the appendix removed. This can be done with an open technique or through laparoscopic appendectomy.

Open Appendectomy

An open appendectomy is a traditional surgical procedure for removing the appendix. It involves making a single, larger incision of about 3-5 inches in the lower right abdomen to access and remove the appendix. While it may leave a more noticeable scar and generally requires a longer recovery period than laparoscopic surgery, open appendectomy is still necessary in some cases, especially when the appendix has ruptured or there are complications. This procedure allows the surgeon to examine the abdominal cavity thoroughly and address any related issues, making it the preferred choice in more complex cases. Despite its slightly longer recovery time and higher chance of wound infection, open appendectomy remains a safe and effective surgical option when needed.

Laparoscopic Appendectomy

It is a minimally invasive surgical procedure used to remove the appendix. The laparoscopic appendectomy involves three small incisions, one in the belly button and 2 on the left lower abdomen. Through these cuts, a laparoscope and other specialized instruments are inserted. The laparoscope is a thin, flexible tube with a camera that allows the surgeon to view the inside of the abdomen on a screen. The appendix can be removed through these small cuts. This approach offers several advantages, including quicker recovery times, smaller scars, and less post-operative pain. Patients often experience a shorter hospital stay and can return to their normal activities sooner. Laparoscopic appendectomy is preferred for uncomplicated cases of appendicitis and is associated with reduced surgical site infections.

Medical treatment with antibiotics

In some cases of very early appendicitis, the condition may also be possibly treated by antibiotics if deemed appropriate by the treating physician.

Possible complications

Potential complications after appendix removal include infection at the site of the removal known as SSI (surgical site infection). Despite careful surgical procedures and sterilization protocols, there is always a risk of bacterial contamination during surgery. Bacteria from the skin or surrounding tissues can potentially enter the surgical site. To minimize the risk of infection at the site of removal of the appendix, it’s crucial for both the surgical team and the patient to follow strict hygiene and post-operative care protocols. Proper wound care, the administration of antibiotics when necessary, and close monitoring of the surgical site are essential to reduce the risk of infection.

At ALSA Pakistan, our commitment to patient safety and quality care is unwavering, and we consider infection control as one of our top priorities. We have established a Central Sterile Services Department (CSSD) that plays a pivotal role in safeguarding our patients’ well-being, particularly during surgical procedures such as laparoscopic appendectomies.

When it comes to laparoscopic appendectomy, our CSSD plays a crucial role in infection prevention through the following measures:

  • Sterilization
  • Quality assurance
  • Adhering to standard protocols
  • Staff training
  • Regular inspections
  • Patient safety  

Our commitment to maintaining the highest standards of infection control is part of our broader mission to provide safe, effective, and compassionate healthcare services to our patients. At ALSA Pakistan, we take every measure to ensure that the risk of infection during laparoscopic appendectomy is minimized, giving our patients the confidence that they are in safe hands.

Frequently Asked Questions

Do we have any dietary restrictions after the
removal of the appendix?

Usually the diet difference includes a liquid, semisolid food or fluid diet for 1-2 weeks after that, normally the patient can resume their regular diet.

What if I develop an infection of the surgical wound?

You will have to follow-up with your doctor and have the infection treated.

If I treat my appendicitis with antibiotics, do I still need to remove the appendix?

No, you do not need it to be removed if the infection is completely treated with antibiotics, unless there is a pain attack again. Then get it checked properly.

What is the recovery period after surgery?

After 1-2 weeks a person can resume their normal activities, however it is recommended to avoid any heavy lifting or strenuous activities for 2 months. 

Is it normal to have diarrhea after surgery?

No, it is not normal to have diarrhea after laparoscopic appendectomy. Contact your doctor right away.

Is it possible to have appendicitis again?

If the first time removal was done appropriately, then there is no chance of having appendicitis again.

Which is better open procedure or laparoscopic appendectomy?

The laparoscopic procedure is now considered as the better choice because of lower chances of wound infection, early recovery, less visible scars, and the reduced chances of developing other complications such as hernia at the site of surgery. Also, laparoscopic procedure allows the evaluation of other potential causes of pain, such as ovarian cyst related pain or pain due to Meckel’s Diverticulum. As this approach provides better exposure of the organs in the abdomen.