Appendectomy is a surgery that is done to remove appendix when it gets infected, a condition referred to as appendicitis. The appendix is located in the right lower part of the belly and is a thin small bag attached to large intestine. In appendicitis, removal of appendix is required immediately as without treatment it may burst. There are two types of appendectomy-open appendectomy (standard method) and laparoscopic appendectomy (less invasive, newer method). Appendectomy is an emergency surgery and quite commonly performed. Usually, there are no complications of the surgery; however, in some cases there may be some complications.
Though appendectomy is relatively free of risks, still some complications may develop. The common complications are as follows:
1. Paralytic Ileus
Under normal conditions, the intestine is under constant systematic and rhythmic motion. During surgery, the intestine may get disturbed, resulting in paralysis of movements. This leads to accumulation of gases and fluids in the intestine, causing its swelling. This complication more commonly occurs when the surgery is done to remove a perforated appendix. There is intravenous administration of fluids and food and a nasogastric tube is passed through the nose in the stomach to relieve the condition.
2. Wound Infection
The skin surrounding the closed incision may get infected, inflamed and filled with pus. You may be prescribed antibiotics depending on the severity of infection. In case there is no improvement, the surgeon may reopen the incision to drain it of toxins and pus.
In some individuals pain may occur in the shoulders as one of the appendectomy complications, particularly post laparoscopic appendectomy. This occurs as a result of carbon dioxide gas which is pumped in the abdomen during the procedure. The condition usually gets better in one or two days on its own. However, chronic pain in abdomen may occur in some people and it may last for even months. In such cases narcotics such as Vicodin, Oxycodone, and Percocet etc. are usually prescribed.
It is very important to consume these medicines according to instructions. These medicines may cause drowsiness; hence, activities including driving must be avoided. Don’t drink alcohol with these medicines and consume them along with meals to prevent nausea. Visit a physician if you develop any symptoms such as rash.
Narcotics and paralytic ileus may result in slowing down of bowel movements leading to constipation. To prevent constipation, you should take stool softeners before appendectomy as recommended by your surgeon.
After discussing appendectomy complications, let’s discuss certain guidelines on recovery after appendectomy.
The time required for recovery after appendectomy is quite variable. It depends on type of surgery done, type of anesthesia used, and whether any complications have developed or not. For instance, laparoscopic appendectomy can be performed on outpatient basis and the patient may be discharged so that they can recover at their home, whereas in open surgery stay in the hospital for one night or longer time may be required after which the patient can go home. You may resume normal activities in few days; however, you may require four to six weeks for full recovery and during this time you should avoid strenuous activities.
Return to Work and School
Each person has a different reaction to pain. A scale of 0 to 10 is utilized to measure pain. At 0, no pain is felt, while at 10, the worst pain is felt.
Opioids or narcotics are utilized for pain that is severe. Possible adverse effects are reduced blood pressure, breathing rate and heart rate, sleepiness, itching and skin rash, nausea, difficulty in urination and constipation. There are medicines that control these adverse effects of narcotics.
Majority of the non-narcotics pain medicines are NSAIDs (nonsteroidal anti-inflammatory drugs). They are utilized for inflammation and mild pain or used in association with a narcotic for severe pain. Certain adverse effects of NSAIDs include bleeding in gut, fluid retention, and stomach upset. They are not present when NSAIDs are used for short term. Some examples are ibuprofen, Aleve, Toradol, and Motrin.
When to Visit Your Surgeon?
In case you have the following: