Complications

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