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Complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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