Appendix surgery, or appendectomy, involves the removal of the appendix. Appendicitis is the main reason for an appendectomy. The surgery can be done through a single incision about 6 cm long or laparoscopically, through a small incision using long, thin instruments and a camera. Appendectomies are common operations but possible complications after surgery do exist.
Infection
Appendicitis is an infection of the appendix. Though removal of the appendix removes the main infection, patients can have residual bacteria that lead to infections. The most common is infection of the wound; it usually can be treated easily with local care and possibly antibiotics. A less common infection is an intra-abdominal abscess, when bacteria from the appendicitis lingers in the abdomen and collects into a pocket of pus called an abscess. Treatment for this requires antibiotics and drainage through a catheter inserted under radiologic guidance. Surgery is rarely necessary.
Bowel Obstruction
After an appendectomy, scar tissue called adhesions develop, forming bands in the abdominal cavity. Any intestinal segment can slip underneath one of these bands or can become stuck to the adhesions. Then a noose-like trap forms around the intestine, and the bowel becomes blocked. Initial treatment starts with resting the intestine by fasting and having intestinal contents sucked out through a tube that passes through the nose to the stomach. Surgery to release scar tissue may be required if the initial treatment fails.
Colon Fistula
The appendix branches off the colon. When it is removed, the resulting hole in the colon is sewn or stapled shut. However, if this stitching breaks down, the hole will slowly reopen. Generally the body will stave off widespread leakage of the colon contents into the abdomen, but a connection between the colon hole and the abdominal wall will form. Eventually, this will erupt through the skin of the abdomen. This connection from the colon to the abdomen is called a fistula. Patients will notice infection and drainage from this region in the skin of the abdomen. Treatment can range from medical management with antibiotics and intravenous feeding to surgery.
Infertility
In women, appendicitis can cause infertility. If the appendicitis leads to rupture without containment, otherwise called diffuse peritonitis, all the organs of the abdomen can be exposed to infection. The fallopian tubes which carry the egg from the ovary to the uterus can become inflamed, possibly resulting in scarring of the tubes, which leads to infertility.
