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Appendectomy in Children and Teens

​By: Laura Hollinger MD FAAP, Steven Lee MD FAAP

An appendectomy is surgery to remove the appendix, a small, pouch-like organ attached to the colon. Your child may need an appendectomy if the appendix becomes infected. An infection of the appendix is called appendicitis.

How is an appendectomy be performed?

Your doctor will discuss the surgery type with you. Surgery to remove the appendix can be done with a single incision on the abdomen. Surgery can also be done with small incisions using a camera and small surgical instruments (this is called laparoscopic surgery). Either type of surgery (open or laparoscopic) could be used to remove the appendix. These days, many surgeons use laparoscopic surgery to remove the appendix because the incisions are smaller and your child will have less pain.

First, your child will be prepared for surgery. They will receive fluids in their IV and antibiotics to treat the infection of the appendix. Fluids and antibiotics are important to make sure your child is ready before surgery.

Your child will not be allowed to eat or drink anything for many hours before surgery. They cannot have any water, ice, chewing gum or anything else to eat or drink. This is because the stomach needs to be completely empty when they go to sleep with anesthesia.

How long will my child be in the hospital?

If your child's appendix did not burst (not ruptured), then the infection was mild. It may be possible that your child goes home very soon after surgery. Your child may not need any more antibiotics or other medicines. Your child will be able to drink and eat.

If your child's appendix did burst (ruptured), then the infection is more serious. Your child will be kept in the hospital for recovery. During recovery, your child will be given more antibiotics through their IV. They will be given liquids then solid food to eat when they feel better. They may be in the hospital for days after surgery. Once they have recovered, have no more fevers and are able to eat, your doctor will tell you when they can go home.

What do I need to do for my child when they go home?

Your child will be encouraged to walk around as soon as possible after surgery. They may have a normal diet after surgery.

  • Activities my child can do. Your child should avoid heavy lifting or strenuous activity for 1-2 weeks after surgery. They can return to school once they are not needing medicines for pain and have energy.

  • Taking care of the wound. The bandages should be kept on the incision for a few days after surgery. The bandages should also be dry and clean. The stitches used on the inside during surgery are usually the type that do not need removal. Your doctor will give you specific instructions.

  • Medicines my child may need to take. Your child may need mild pain medicine like acetaminophen or ibuprofen. They should be taken as described on the bottle if needed for pain. If your doctor gives your child stronger medicines for pain, there will be specific instructions for how it should be given. Some children will need antibiotics too and your doctor will give them if necessary.

When should I call the doctor?

You should call your child's doctor if your child develops a fever, pain in the belly, vomiting, diarrhea or if the wounds look red or drains fluid. Sometimes children can have problems related to surgery for the appendix, which your doctor can check for and treat. Any problems typically happen soon after surgery. Examples include a wound infection, abscess, or bowel blockage.

  • Wound infection. This is when an infection forms at one of the surgery incisions. The incision will appear red, be painful to your child, and possibly drain pus or liquid. This may need treatment with antibiotics or drainage. You should call your child's doctor if you see redness or drainage at one of the surgical incisions.

  • Abscess. An abscess is a pus pocket that can sometimes form inside the abdomen. An appendix that had burst is a more serious infection and more likely to cause an abscess. If your child develops fevers, new belly pain or vomiting, you should call their doctor. Your child's doctor may order tests to determine if there is an abscess after surgery to remove the appendix. If an abscess is found, your child may need more antibiotics or drainage of the pus.

A​re there lasting effects from appendectomy?

After surgery to remove the appendix, your child will return to normal. The appendix is not a vital organ, so your child will continue to grow up and be healthy without an appendix.


More information

About Dr. Hollinger

Laura Hollinger, MD, FAAP, who serves on the American Academy of Pediatrics Section on Surgery, is an assistant professor of surgery in at the Medical University of South Carolina. She also serves as Medical Director of the pediatric Extracorporeal Membrane Oxygenation (ECMO) program at the Shawn Jenkins Children's Hospital. She maintains a comprehensive practice in pediatric general surgery covering a wide range of clinical areas. Her research interests include congenital diaphragmatic hernia, prenatal consultation, and pediatric ECMO support during critical illness.

About Dr. Lee

Steven Lee, MD, FAAP, is a Clinical Professor of Surgery and Pediatrics at the David Geffen School of Medicine at University of California, Los Angeles (UCLA). He is also the Division Chief of Pediatric Surgery at UCLA and Surgeon-in-Chief of UCLA Mattel Children's Hospital. On the national level, Dr. Lee currently serves on the American Academy of Pediatrics Section on Surgery and the Pediatric Surgery Board of the American Board of Surgery. He also chairs the Education Committee and is a member of the Professional Development Committee of the American Pediatric Surgical Association.


Last Updated
7/20/2021
Source
American Academy of Pediatrics (Copyright © 2021)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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