The primary goal in the treatment of appendicitis is to remove the inflamed appendix before it ruptures. When the appendix ruptures, pus spills into the abdomen, resulting in peritonitis. Peritonitis is more difficult to treat, and requires a longer stay in the hospital. If the appendix has ruptured, the doctor must perform open abdominal surgery, which requires a 2-4 inch (5-10 cm) incision in the right-lower abdomen. If the appendix has not ruptured, the doctor may perform laparoscopy to remove the appendix. The laparoscope is a long flexible tube that allows a doctor to view the inside of the abdomen. This procedure reduces the size of the incision in the abdominal wall, and allows for faster recovery than open surgery.
The treatment for appendicitis includes:
- Nothing by mouth
- Intravenous fluids
- Narcotic pain medication:
- Intravenous antibiotics:
- Metronidazole (Flagyl)
- Gentamicin (Gentacidin, Garamycin)
- Cefotetan (Cefotan)
- Cefoxitin (Mefoxin)
- Meropenem (Merrem)
- Piperacillin and tazobactam sodium (Zosyn)
- Ampicillin and sulbactam (Unasyn)
- Open abdominal surgery
Appendicitis Questions For Doctor
The following are some important questions to ask before and after the treatment of appendicitis.
Questions to ask before treatment:
- What are my treatment options?
- Is surgery an option for me?
- What are the risks associated with treatment?
- Do I need to stay in the hospital?
- How long will I be in the hospital?
- What are the complications I should watch for?
- How long will I be on medication?
- What are the potential side effects of my medication?
- Does my medication interact with nonprescription medicines or supplements?
- Should I take my medication with food?
Questions to ask after treatment:
- Do I need to change my diet?
- Do I need to lose weight?
- Are there any medications or supplements I should avoid?
- When can I resume my normal activities?
- When can I return to work?
- Do I need a special exercise program?
- How often will I need to see my doctor for checkups?
- What local support and other resources are available?
Surgery to remove the appendix is called an appendectomy.
The two types of appendectomy include:
- Open appendectomy:
- An incision is made in the right lower abdomen and the appendix is removed through the incision.
- Laparoscopic appendectomy:
The laparoscope cannot be used if the surgeon suspects that the appendix has ruptured.
Continue to Appendicitis Warning Signs
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- Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg. 2004 Jan;91(1):28-37. 
- Hagendorf BA, Clarke JR, Burd RS. The optimal initial management of children with suspected appendicitis: a decision analysis. J Pediatr Surg. 2004 Jun;39(6):880-5. 
- Shelton T, McKinlay R, Schwartz RW. Acute appendicitis: current diagnosis and treatment. Curr Surg. 2003 Sep-Oct;60(5):502-5.