Open Appendectomy In Children

WHAT YOU SHOULD KNOW:

An open appendectomy is surgery to remove your child's appendix through an incision in his lower abdomen.


CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

  • After surgery, your child may get an infection or a fever. Your child may also get pneumonia (an infection in his lungs). Organs may be damaged or push through the incision site. Scar tissue may form inside his body and cause tissue and organs to stick together. Your child's bowels may become blocked and stop working properly. Your child may get an abscess, which is a pus filled pocket of tissue that can cause infection. Your child may bleed more than expected during surgery or may require another surgery. Your child may get a serious infection in his blood and he could die.

  • Without surgery, your child's appendix may burst open. If this happens, the infection inside of your child's appendix may spread to other organs and his blood. The infection may kill nearby tissue and cause your child to bleed in his abdomen. If this infection is not treated, it can be life-threatening.

WHILE YOU ARE HERE:

Before your child's surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

  • Preoperative care: Medicine may be given to help your child relax. Your child will be taken to the room where the procedure or surgery will be done.

  • Special lines: Some tubes may be put into an artery or vein (blood vessel) before, during, or after surgery. These help caregivers watch how your child is doing during or after surgery. Your child may need the following lines:

    • An IV is a small tube placed in your child's vein that is used to give him medicine or liquids.

    • NG tube: This is also called a nasogastric tube. An NG tube is put down your child's nose and into his stomach. An NG tube keeps air and fluid out of the stomach during surgery. It is usually taken out shortly after surgery.

    • Arterial line: This tube is also called an "art line" or an "A-line". It is placed into an artery, usually in the wrist or groin. The groin is the area where your child's abdomen (belly) meets his upper leg. The art line is attached to tubing with liquid in it. This liquid helps keep the tubing from getting plugged. The tube may be used for measuring your child's blood pressure or for drawing blood.

    • CVP line: A CVP line is also called a central line. It is an IV catheter or tube. It is put into a large blood vessel near your child's neck, groin, or near his collarbone. The CVP line may be used to give medicines, draw blood, or to check your child's heart.

      • Peripherally Inserted Central Catheter (PICC line): This tube is a central line put into your child's arm. PICC lines are used to give medicines or fluids. Your child may need a central line if it is hard for caregivers to insert a regular IV. A central line may also stay in longer than a regular IV can. Some central lines may also be used to take blood samples. A PICC line may be used to give your child antibiotic medicine. Antibiotics may help prevent your child from getting an infection.


  • General anesthesia will keep your child asleep and free from pain during surgery. Anesthesia may be given through your child's IV. He may instead breathe it in through a mask or a tube placed down his throat. The tube may cause your child to have a sore throat when he wakes up.

During your child's surgery:

  • Your child's caregiver makes a small cut through your child's lower abdomen. Your child's caregiver removes any pus or extra fluid that he sees. Your child's appendix is carefully raised with special tools. The tissue lining that attaches the appendix to your child's bowel is cut. Blood vessels that bring blood to or from your child's appendix are tied off with stitches.

  • Your child's caregiver removes your child's appendix. The stump of your child's appendix is closed off with stitches. The stump may be placed back inside your child's bowel. Caregivers may wash the inside of your child's abdomen to remove any remaining infection. If pus remains inside your child's abdomen, his caregiver may place a drain in his wound. Your child's caregiver closes your child's cut with stitches or staples. Your child's appendix may be sent to a lab for testing.

After your child's surgery:

Your child will be taken to a room where he can rest until he wakes up. Your child should not get out of bed until his caregiver says it is okay. Your child may be sleepy and have some pain after surgery. Caregivers will check on your child. Your child will be taken back to his hospital room once your caregiver decides it is okay. Leave any bandages on your child until a caregiver takes them off

  • Blood tests: Your child may need blood taken for tests. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV. Blood tests can help your child's caregiver look for signs of infection. Your child may need to have blood drawn more than once.

  • Eating: Your child may be able to eat when caregivers hear bowel sounds (stomach growling). A caregiver will listen for bowel sounds by putting a stethoscope on your child's belly. Ice chips are usually given first. Then liquids like water, broth, apple juice, or clear soda are given. If your child does not have problems after drinking liquids, a caregiver may let your child eat soft foods. Some examples of soft foods are ice cream, applesauce, or pudding. If your child can eat soft food without problems, he may begin eating a regular diet.

  • Medicine:

    • Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.

    • Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Open Appendectomy In Children (Inpatient Care)

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