ABDOMINAL EMERGENCY · CONDITION GUIDE

Appendicitis

Q: Can appendicitis be treated with antibiotics alone?

Selected patients with uncomplicated appendicitis (no perforation or abscess) may be treated with antibiotics alone in the short term, avoiding immediate surgery. However, recurrence occurs in approximately 25–40% within 5 years, and the majority ultimately require appendectomy. Surgery remains the gold standard definitive treatment.

Q: How quickly do I need to have surgery for appendicitis?

Surgery should be performed within 24 hours of diagnosis for uncomplicated appendicitis. Delay beyond 24–36 hours significantly increases the risk of perforation and its associated complications — abscess formation, peritonitis, and prolonged hospital stay.

Q: What happens if the appendix perforates?

A perforated appendix causes faecal contamination of the peritoneal cavity, resulting in peritonitis, sepsis, and abscess formation. Surgery remains necessary but may be technically more demanding. A longer hospital stay, intravenous antibiotics, and occasionally percutaneous drainage of pelvic abscesses are required. Full recovery takes longer than uncomplicated appendicitis.

Acute inflammation of the appendix causing progressive abdominal pain — the most common abdominal surgical emergency, treated by laparoscopic appendectomy.

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Emergency Laparoscopic Appendectomy for Appendicitis by Dr. Tagore

Most Common ABDOMINAL EMERGENCY

30–60 Min PROCEDURE DURATION

1–2 Days HOSPITAL STAY

ABOUT THIS CONDITION

What is Appendicitis?

Appendicitis is inflammation of the vermiform appendix, most commonly caused by luminal obstruction by a faecolith followed by bacterial overgrowth. It presents with central abdominal pain migrating to the right iliac fossa, nausea, vomiting, and fever. Untreated, it progresses to perforation, peritonitis, and life-threatening sepsis. It is the most common abdominal surgical emergency, with a lifetime risk of approximately 7–8%. Dr. Tagore Mohan Grandhi performs laparoscopic appendectomy for appendicitis at Lux Hospitals, Hyderabad. The laparoscopic approach is the gold standard, offering faster recovery, reduced post-operative pain, lower wound infection rates, and same-day or next-day discharge in uncomplicated cases.

SIGNS TO WATCH

Common Symptoms

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Symptoms that need attention

Central abdominal pain migrating to the right iliac fossa (McBurney’s point) Nausea, vomiting, and anorexia Low-grade fever and elevated white cell count Guarding and rebound tenderness in the right lower abdomen Rovsing’s sign — right iliac fossa pain on palpating the left lower quadrant Peritonitis and board-like abdomen if the appendix has perforated

WHY IT HAPPENS

Causes & Risk Factors

Luminal obstruction by a faecolith (hardened stool) triggering inflammation
Lymphoid hyperplasia following a viral infection — particularly in children
Inspissated mucus or parasites in the appendiceal lumen
Carcinoid tumour or other neoplasm causing obstruction
Bacterial overgrowth following obstruction leading to ischaemia and perforation
No single identifiable cause in all cases

CLINICAL DETAILS

KeyFacts

Lifetime Risk

Approximately 7–8% of the population

Gold Standard

Laparoscopic appendectomy

Timing

Urgent surgery within 24 hours of diagnosis

Perforation Risk

Increases significantly with delayed diagnosis

Recovery

Discharge in 1–2 days; return to work in 1–2 weeks

Hospital

Available at Lux Hospitals, Hitech City, Hyderabad

HOW WE TREAT IT

Treatment Approach

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Laparoscopic Appendectomy

Laparoscopic appendectomy removes the inflamed appendix through three small keyhole incisions, with significantly less post-operative pain, faster return to normal activities, and lower wound infection rates compared to open surgery. Dr. Grandhi performs laparoscopic appendectomy as the standard approach at Lux Hospitals, with excellent outcomes in both uncomplicated and perforated cases.

Available at Lux Hospitals, Hitech City, Hyderabad

1

Diagnosis & Assessment

Clinical examination, white cell count, and CRP confirm the diagnosis. CT abdomen or ultrasound is used in equivocal cases to exclude alternative diagnoses and identify perforation or abscess.
2

Emergency Surgical Preparation

Intravenous antibiotics, fluids, and analgesia are commenced. Surgery is planned within 24 hours of diagnosis. Laparoscopic approach is standard; open surgery is reserved for complicated cases.
3

Laparoscopic Appendectomy

Three small incisions provide laparoscopic access. The mesoappendix is divided and the appendix base secured with clips or an endoloop before division and extraction in a retrieval bag. The peritoneal cavity is irrigated.
4

Recovery & Follow-up

Oral fluids commence post-operatively. Most patients are discharged within 1–2 days. Histology confirms the diagnosis and excludes underlying pathology. Return to work in 1–2 weeks.

AVAILABLE TREATMENTS

TreatmentOptions

Laparoscopic Appendectomy

Gold-standard keyhole removal of the inflamed appendix through three small incisions with rapid recovery and low complication rates.

Appendectomy (Open)

Open removal of the appendix through a right iliac fossa incision, used for complex or perforated cases, or where laparoscopic approach is not feasible.

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COMMON QUESTIONS

Frequently Asked Questions

Can appendicitis be treated with antibiotics alone?+

How quickly do I need to have surgery for appendicitis?+

What happens if the appendix perforates?+

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