Kids Health Info

Appendicitis 2 - Removing the appendix

  • Before reading this factsheet, please read Kids Health Info factsheet: Appendicitis (1) - Infected appendix.

    Pronounciation:
    Appendicitis - uh-pen-deh-sye-tus
    Appendix - uh-pen-diks
    Appendicectomy - uh-pen-da-sect-a-me

    Appendicectomy

    If the appendix is infected it is usually necessary to remove it with an operation called an appendicectomy. There are two different ways to take out the appendix:

    • Laparoscopic - through a tiny telescope. There will be three small keyhole cuts about 1-2cm long each.
    • Open - there will be a small cut across the abdomen (tummy) about 5-7cm long. 

    The type of operation your child has will depend on how severe doctors think the appendicitis is. The surgeon (doctor who will be performing the operation) will discuss this with you.

    Before the operation

    • Your child must not have anything to eat or drink as per the fasting guidelines (at least six hours before the operation your child must not have milk, food, lollies or chewing gum). 
    • The surgeons, anaesthetist (doctor who puts your child to sleep during the operation), other doctors and nurses will explain all procedures to you.  
    • It is easy to get overwhelmed with so many people talking to you, especially when your child is sick. If there is anything you want to know and are not clear about, please ask staff to explain as many times as is needed.

    After the operation

    After the operation your child:

    • Will stay in the recovery room until they are awake, and then go to the ward.
    • May be sleepy.  A nurse will take observations (i.e. heart rate, breathing rate, blood pressure) of your child often.
    • Will get fluids through an IV (intravenous or into a vein) drip until they can eat and drink again.
    • Will get medicine through their IV drip to stop them feeling sick (nauseous) or vomiting.
    • Their surgeon will talk to you about what happened during the operation.

    Eating

    Doctors will tell you when and what your child can eat and drink. What they can eat is upgraded as your child can manage. For example, your child will be able to progress from:

    • clear fluids - water and cordial, to
    • free fluids - custards and yoghurts, to
    • light diet - sandwiches, soup.

    If you are not sure what your child can eat, please ask. It is very important to follow what staff say. The bowel may need to be empty of food or fluid so it can rest after the operation. Trying to eat and drink before the bowel has recovered means it can actually take longer before your child can eat normally again.

    General information

    • Your child may need to have strong pain medicine such as morphine or Patient Controlled Analgesia (PCA). Sometimes children only need simple pain medicine such as paracetamol (Panadol), ibuprofen or tramadol.
    • A clear dressing or steri-strips will be put over the wound/s. Nursing staff will check this from time to time after the operation.
    • Your child will be in hospital for approximately three days. However, if your child has had a perforated (burst) appendix then they will have to stay in hospital for a longer period to receive extra antibiotics.  This is normally about five to seven days.

    Appendicitis - in hospital
    Care at home

    Your child should:

    • Stay home from school for one week and avoid sports for two weeks, but these times will depend on how sick your child has been. Always ask your family doctor or surgeon if you're not sure.
    • Be able to eat and drink as normal.
    • Be able to shower and bath as normal. There will be a waterproof dressing over the wound site/s. The dressing needs to be left on so the scar can heal, and to stop the wound from getting infected. The stitches are dissolvable and do not need to be taken out. The dressing can come off after seven days.
    • Be in minimal pain. You can give paracetamol or ibuprofen as directed, if your child is in pain.

    When to come back

    Before you leave the hospital, an appointment will be made for you to come back and see the surgeon. Please make sure that you either have this appointment or know who to contact.

    There is a risk of developing an infection after having a ruptured appendix. Contact the surgeon earlier than the scheduled appointment if:

    • Your child gets a raised temperature (temperature above 38.5oC).
    • The wound starts to look infected - for example, it looks red and inflammed, has a discharge or becomes more painful.
    • Your child has increasing pain that is not controlled by regular paracetamol.

    Key points to remember

    • An appendicectomy, sometimes called an appendectomy,  is an operation to remove the appendix.
    • A diagnosis of appendicitis needs to be made quickly. A burst appendix can make a child very sick.
    • There are two different ways to perform an appendicectomy - either laparoscopic or open.
    • Your child will be in hospital for three to seven days depending on the severity of the appendix infection.
    • If your child has had a perforated (burst) appendix they will have to stay in hospital for longer to have antibiotics.
    • Always take your child to see a doctor and, if necessary, a second opinion if you are worried. 

    For more information

     

    Developed in consultation with the RCH Department of Surgery. Many thanks to the parents involved in factsheet development. First published Mar 2006. Updated September 2012.

We want your feedback!  

Please complete this short survey (takes 2 minutes) to help us further improve this resource, thank you. 


Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.