complications
Last reviewed 01/2018
The complications of appendicectomy are reduced in frequency if early diagnosis and operation is attained:
- paralytic ileus:
- treated by analgesia, e.g. morphine, gastric aspiration, careful IV fluid and electrolyte replacement, and antibiotic therapy based on the results of cultures
- ileus usually relents after 3-4 days; beyond this mechanical obstruction becomes a more likely cause of symptoms
- local wound infection:
- features include new wound pain, fever and signs of local inflammation
- treated by removing sutures or inserting sinus forceps in order to release the pus
- pelvic abscesses:
- especially common after the removal of a perforated, gangrenous appendix
- may drain spontaneously via the rectum or vagina or it occasionally requires operative drainage
- subphrenic abscess:
- relatively rare, even after perforated appendicitis
- usually occurs 2-3 weeks after generalised peritonitis
- pylephlebitis:
- features include fever, rigors and jaundice
- after blood cultures, intravenous antibiotics should be commenced
- intestinal fistula