Appendicitis

Appendicitis is inflammation and infection of the appendix, a small pouch attached to the first part of the large bowel. It is a common surgical emergency. If untreated, the appendix can perforate (burst), causing infection to spread within the abdomen.

Symptoms often begin as central abdominal pain that moves to the lower right side, and may be associated with nausea, vomiting, fever, loss of appetite, or diarrhoea/constipation.

Assessment and Investigation

Diagnosis is based on clinical assessment and supportive investigations.

Clinical examination and assessment of pain pattern
Blood tests (infection markers and kidney function)
Urine testing (to exclude urinary causes)
Pregnancy test in women of childbearing age
Imaging if needed:
- Ultrasound
- CT scan

Urgent assessment is required if pain is worsening, there is high fever, persistent vomiting, or severe generalised abdominal pain.

What to expect

Before Your Surgery

This is often an urgent procedure. Authorization will be arranged by the rooms or hospital staff.
Fasting is required; in emergencies you may already be fasting due to nausea/vomiting.
Most chronic medications will be reviewed and adjusted.
Inform your doctor if you are taking blood-thinning medication.
Antibiotics are commonly given before surgery.

Day of Surgery

Appendicectomy is performed under general anaesthesia. You may have:

An IV drip for fluids and medication
A urinary catheter in selected cases
Occasionally a drain if contamination or abscess is present

Pain control will be provided and early mobilisation is encouraged.

Procedure

Treatment is usually appendicectomy (removal of the appendix), performed laparoscopically (keyhole) in most cases.

Small incisions are made in the abdomen.
A camera and instruments are used to remove the appendix.
The abdomen is inspected for contamination or complications.
If the appendix has perforated or an abscess is present, additional washing/drainage may be required.
In some cases, conversion to open surgery may be necessary for safety.

In selected cases (early uncomplicated appendicitis), antibiotic treatment may be considered, but surgery remains the standard definitive treatment.

Procedure Length

The operation typically takes 30–90 minutes, depending on inflammation and complexity.

Possible Complications

Bleeding
Infection (wound or intra-abdominal)
Abscess formation
Injury to bowel, bladder, or blood vessels
Unintended damage to surrounding structures
Post-operative ileus (temporary bowel slowing)
Blood clots (DVT/PE) or chest infection
Need for further procedures or surgery (especially if perforated)
Contact the rooms or seek urgent medical attention if you develop increasing abdominal pain, fever, persistent vomiting, wound redness/discharge, or abdominal swelling.

Duration of Hospital Stay

Uncomplicated appendicitis: usually 1–2 days
Perforated appendicitis or abscess: 3–7 days or longer, depending on recovery and antibiotics

Discharge Instructions

Take prescribed pain medication and antibiotics (if provided) as directed.
Keep wounds clean and dry; follow dressing instructions.
Avoid heavy lifting for 2–4 weeks.
Eat light meals initially and stay well hydrated.
Monitor for fever, worsening pain, vomiting, or wound infection.

Return to Activities

Walking is encouraged from early on.
Avoid strenuous exercise and heavy lifting for 2–4 weeks.
Driving is usually safe after 5–7 days, once comfortable and not using strong pain medication

Appendicitis

Assessment and Investigation

What to expect

Before Your Surgery

Day of Surgery

Procedure

Procedure Length

Possible Complications

Duration of Hospital Stay

Discharge Instructions

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