Do Not Underestimate Abdominal Pain: Appendectomy (Appendicitis Surgery)

Appendicitis is the inflammation of the appendix, an organ located at the beginning of the large intestine. The surgical removal of this inflammation from the body is called an appendectomy (appendicitis surgery). Presenting with severe pain in the lower right abdomen, this condition is a serious health issue that requires emergency intervention and can carry vital risks if not treated in time.

• Appendicitis occurs as a result of a blockage or infection of the appendix at the end of the cecum.
• The most prominent complaint is severe pain that starts around the navel and moves down to the lower right abdomen.
• Blood tests, ultrasonography, and computed tomography are used during the diagnosis phase.
• The gold standard treatment method is a laparoscopic appendectomy performed using a closed technique.
• In untreated cases, the risk of a ruptured appendix arises.

What is an Appendectomy and Who Gets It Most Often?

The clearest answer to what an appendectomy is: the surgical removal of an inflamed appendix. The appendix, a thin tube-like structure averaging ten centimetres long attached to the cecum (the first part of the large intestine), rapidly becomes inflamed when blocked. This inflammatory state is medically termed acute appendicitis.

It is one of the most common emergency operations in general surgery clinics. Although it can occur at any age, statistically it is most frequently seen in individuals between the ages of ten and thirty. If not diagnosed early, this condition—which can also be seen in advanced ages or very young children—can pave the way for serious health problems. While it is thought to make minor contributions to the immune system during early childhood, the removal of the appendix in adulthood does not cause any loss of function in the body.

What Causes Appendicitis and What Are the Risk Factors?

The primary cause of appendicitis is the blockage of the inner cavity (lumen) of the appendix for any reason. This blockage usually occurs when hardened pieces of stool (fecaliths) become trapped in the area. Mucus begins to accumulate in the blocked area, and the internal pressure of the organ increases.

With increasing pressure, bacteria in the area multiply rapidly, leading to infection. Enlarged lymph nodes following digestive system infections can also press on the appendix canal from the outside, causing a blockage. In rarer cases, foreign objects, parasites, or benign tumours are the source of the blockage.

The risk is slightly higher, especially in individuals with a family history of similar surgeries. Swelling of lymph tissues in people who have had severe infections affecting the digestive system can indirectly increase this risk.

Appendicitis Symptoms: Pay Attention to Severe Abdominal Pain

Appendicitis symptoms usually follow a typical route and worsen over time. In the first few hours, a vague, dull ache is felt around the belly button or the upper part of the stomach. Patients often confuse this with a simple stomach bug or indigestion. However, in the following hours, typically within twelve to twenty-four hours, the pain settles in the lower right abdomen and becomes sharp.

Tenderness that increases with movement is one of the most characteristic signs. You may notice that the pain intensifies when walking, coughing, laughing, or pulling your right leg toward your abdomen. This condition is medically known as peritoneal irritation.

Loss of appetite stands out among other symptoms accompanying the pain. The loss of appetite is so pronounced that patients do not even want to see their favourite foods. Mild fever, nausea, and sometimes vomiting can also be added to the clinical picture.

How Is It Diagnosed? (Ultrasound, Tomography, Blood Test)

An accurate diagnosis is vital for patients presenting with abdominal pain. Your physician will first perform a detailed physical examination. Severe pain caused by the sudden release of pressure applied manually to the lower right abdomen is a strong sign of inflammation.

To support the examination, a blood test is requested in the first stage. High levels of white blood cells (leukocytes) and CRP in the blood indicate an active infection in the body. However, imaging methods are needed for a definitive diagnosis. Especially in children, pregnant women, and thin individuals, the first choice is an ultrasound (USG) examination. The swollen and inflamed appendix can be easily visualised with ultrasonography.

In adults and cases where ultrasound is insufficient, the gold standard is a computed tomography (CT) scan. While a CT scan provides a definitive diagnosis of appendicitis, it also greatly helps distinguish the pain from other possible intra-abdominal problems, such as gallstones or, in older patients, colon cancer.

Appendicitis Treatment: Laparoscopic (Closed) Appendectomy

The gold standard treatment for acute appendicitis is surgery. Thanks to modern medical technologies, we now perform the vast majority of appendicitis surgeries using laparoscopic appendectomy, that is, the closed method. This method provides great comfort to the patient both during the surgery and the recovery process.

During closed appendicitis surgery, three small incisions ranging from half to one centimetre are made in the abdominal area. A high-resolution camera and special surgical instruments are inserted through these incisions. The surgeon clearly sees the inside of the abdomen on a screen and removes the inflamed organ without damaging surrounding tissues.

Because there is no large surgical incision, postoperative pain is minimal, and there is almost no scar left. Our patients can usually be discharged to return to their daily lives the day after the surgery. While returning to desk jobs takes three to five days, it is recommended to wait four weeks for heavy sports.

Ruptured Appendix and Possible Complications

One of the most frequently asked questions by our patients is whether this condition can be cured with medication. Since appendicitis occurs as a result of a mechanical blockage, antibiotic treatment alone is usually not enough. In cases that are not intervened or diagnosed late, the risk of a ruptured appendix (perforation) arises.

A ruptured appendix means the stretched organ wall tears and the inflamed fluid inside spreads into the abdominal cavity. In this case, a widespread inflammation of the abdominal lining called peritonitis develops, which is much more difficult to treat and carries a vital risk.

When such a complication develops, the scope of the surgery expands. The inside of the abdomen must be completely washed and cleaned. The hospital stay is prolonged, and strong intravenous antibiotic treatments are needed after surgery. For this reason, a 'wait and see' approach to abdominal pain is quite dangerous.

When Should You See a Doctor and Go to the Emergency Room?

Abdominal pain can be caused by many different reasons, but some warning signs require emergency medical intervention. If you experience one or more of the following symptoms, you should seek medical attention without wasting time:

• Sharp pain that starts suddenly in the lower right abdomen and gradually worsens.
• Inability to stand up straight due to pain, the need to walk hunched over.
• High fever and shivering spells accompanying the pain.
• Severe and continuous vomiting that even prevents fluid intake.
• A board-like rigidity and extreme tenderness when your abdomen is touched.

You should definitely not use painkillers while these symptoms are present. Painkillers can mask the clinical picture and make diagnosis difficult. Likewise, placing a hot water bottle on the aching area should absolutely not be done, as it can accelerate the spread of inflammation and the rupturing of the organ.

Appendicitis Treatment at BHT CLINIC İstanbul Tema Hastanesi

When you apply to our hospital with suspected severe abdominal pain, you are quickly evaluated by our Emergency Department team, which provides uninterrupted service 24/7. The necessary initial blood tests and imaging procedures are organised without wasting time.

Following the diagnosis process, the experienced physicians of our General Surgery clinic step in. The safest intervention is performed in our hospital's operating rooms equipped with advanced technology, in accordance with laparoscopic surgery principles.

Thanks to our multidisciplinary approach, all your processes before, during, and after the surgery are meticulously followed. After a short stay in our comfortable patient rooms, you are ensured to return home healthily. Our expert staff is always by your side for early diagnosis and correct surgical intervention.

For detailed information and examination, you can consult our specialist physicians by booking an appointment.

Frequently Asked Questions

What is an appendectomy and how long does the surgery take?

An appendectomy is the surgical removal of the inflamed appendix. A standard surgery performed with the closed (laparoscopic) method is usually successfully completed between thirty and sixty minutes.

How should nutrition be after appendicitis surgery?

Approximately four to six hours after the surgery, with the start of bowel movements, water and liquid foods begin to be consumed. A normal diet can be resumed the next day; however, easy-to-digest, fibrous foods should be preferred in the first weeks.

Will there be a scar after closed appendicitis surgery?

In closed surgery, only three small incisions of half a centimetre are made in the abdominal area. Since these incisions are closed with aesthetic stitches, there is no visible, distinct scar left when healing is complete.

Will there be a deficiency in the body if the appendix is removed?

The appendix has no known vital function in the adult human body. Therefore, the surgical removal of the organ does not cause any deficiency or loss of function in the digestive or immune system.

Does appendicitis pain go away on its own at home?

Since acute appendicitis develops as a result of a mechanical blockage, it does not go away with methods applied at home or on its own. When medical intervention is delayed, serious complications carrying a vital risk, such as a ruptured appendix, can arise.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.