Appendectomy for Children

What is an appendectomy for children?

An appendectomy is surgery to remove a child’s appendix. The appendix is a small pouch that’s attached to the junction of the small and large intestine. It's typically located on the lower right side of the belly (abdomen).

An appendectomy may be done as an open surgery. This involves making a cut (incision) into the belly and removing the appendix. An appendectomy may also be done through 1 cut or a few smaller cuts using a camera and small tools. This is called a laparoscopic surgery.

Why might my child need an appendectomy?

The function of the appendix is not fully known. Many experts think there's no specific function.

Sometimes the appendix becomes blocked. Mucus trapped inside can allow bacteria to grow. That can lead to infection and inflammation (appendicitis). This illness is very common in children, teens, and young adults. A young person with this problem often needs an appendectomy.

An appendix that is inflamed can burst if it's not taken out. If that happens, infection can spread all over the belly. It can cause a dangerous health problem called peritonitis.

What are the risks of an appendectomy for a child?

As with other surgeries, the possible risks of this procedure include:

• Bleeding

• Infection

• Problems from the anesthesia

Other possible risks are:

• Leakage from the large intestine where the appendix was removed

• The need for a longer hospital stay and antibiotic medicines if the appendix has burst before the surgery

• Injuries to nearby organs during the surgery

There may be other risks, depending on your child’s health. Talk with your child’s healthcare provider about any concerns before the procedure.

How do I help my child get ready for an appendectomy?

An appendectomy is often an emergency surgery. Your child may not have a lot of time to get ready for it. The healthcare team will want to know when your child last ate. That’s because having food in the stomach can cause problems when your child is under anesthesia. If the surgery is planned ahead of time, ask the healthcare provider when your child should stop eating and drinking beforehand.

Before the procedure starts, the healthcare team may give your child a shot of medicine to help them relax. Your child will also have an IV (intravenous) line placed into a vein so fluids and other medicines can be given. This is how your child will be put to sleep for the surgery.

What happens during an appendectomy for a child?

During an open procedure, the surgeon will make an incision into the skin and the fat underneath. This incision will be 1 to 2 inches long. Upon reaching the appendix, the surgeon will remove it. The surgeon will then close the opening in the intestine and the skin.

During a laparoscopic procedure, the surgeon will make a few small incisions in the belly. The surgeon will put a tiny camera through one incision so they can see the procedure on a video screen. The surgeon will put air into the abdomen through a tube to inflate the area so they can see better. The surgeon will then remove the appendix using small tools. When finished, the surgeon will stitch up the opening in the intestine and any of the small incisions in the skin.

If your child’s appendix has burst, a drainage tube may be left in the belly for a few days. This is to drain away any extra fluid that may collect. Sometimes the surgeon may plan a laparoscopic surgery. But they may need to switch to an open surgery when it seems like a safer choice.

What happens after an appendectomy for a child?

After the surgery, your child will go to the postanesthesia care unit (PACU). They'll be closely watched there before being sent to a regular room. Some children may be able to go home from the recovery room. Your child will get pain medicine through the IV, then later by mouth.

Your child will be encouraged to get up and move around later that day or the next day. After laparoscopic surgery, your child may feel cramps or shoulder pain. This is referred pain from the air that was put into the abdomen. Children often go home a day or two after the surgery. If the appendix ruptured before the surgery, your child may need to stay in the hospital for up to a week. In these cases, your child may need IV antibiotics for a week or more.

Your child should not do any physical activities until the surgeon says it’s OK. This will often be at a follow-up visit. Follow the healthcare provider’s directions on bathing and taking care of the incision.

Call your child’s healthcare provider if your child has:

• A fever of 100.4°F (38°C) or higher, or as advised by the provider

• Belly swelling

• Green or yellow drainage from any incision

• Pain that gets worse as hours or days pass

• Redness or swelling around the incision

• Sluggishness

• Vomiting or diarrhea

Next steps

Before you agree to the test or the procedure for your child, make sure you know:

• The name of the test or procedure

• The reason your child is having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• When and where your child is to have the test or procedure

• Who will do the procedure and what that person’s qualifications are

• What would happen if your child did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or your child has problems

• How much you will have to pay for the test or procedure