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If you have appendicitis, you will normally need surgery to take out your appendix. Your doctor may call this an appendectomy.

Your appendix can be removed through open surgery, when the surgeon makes a cut in your lower abdomen. Or it can be done through keyhole surgery, which is done using three or four smaller cuts, and with the help of cameras. Keyhole surgery is also called laparoscopy.

When you go to your doctor with pain in your abdomen, he or she will feel the area to see if it is tender. If your doctor thinks you might have appendicitis he or she may do some tests, such as blood tests. If you are a woman, your doctor may suggest a test to see if you're pregnant. That's because appendicitis can be more difficult for your doctor to spot if you're pregnant.

Your doctor may do other tests as well, such as a CT scan or an ultrasound. These help your doctor see your appendix and decide if it is inflamed.

Sometimes your doctor may not be sure whether you have appendicitis. This is more likely if you are a woman. To find out for sure whether you have appendicitis, your doctor may do laparoscopy (keyhole surgery) to look inside your abdomen. If you have appendicitis, your appendix can be taken out during the operation.

It's difficult to say what would happen to you if you got appendicitis and didn't have surgery. Sometimes an inflamed appendix bursts. This can cause a dangerous infection in your abdomen, called peritonitis. Between about 2 in 10 and 4 in 10 people get a burst appendix a day or two after they first get symptoms of appendicitis.¹ So, doctors think it is very important to take out a person's appendix quickly.

A burst appendix is more common in babies, young children and older people. That's because appendicitis is harder for doctors to spot in children and older people.¹ If your appendix does burst, you'll probably need emergency surgery. And you'll be given antibiotics to treat infection. A burst appendix is more serious than ordinary appendicitis, but most people still recover well.

We don't know what happens to people who don't have surgery for appendicitis. It wouldn't be fair to do studies, because we know that a burst appendix can be dangerous. However, some people do seem to get appendicitis that comes and goes on its own.^{2 3 4}

After surgery, most people recover very well from appendicitis. All operations have risks. It is possible for someone to die during surgery to remove their appendix. But the risk is very small. Less than 3 in 1,000 people die during the operation or soon afterward.⁵ If someone's appendix bursts before surgery, the risk is slightly higher, but most people still recover completely. About 17 in 1,000 people die if their appendix bursts before they have surgery.⁵

Some other problems that might happen after surgery for appendicitis are:

• An infection in the place where the surgeon cuts your skin
• An infection and sac of pus inside your abdomen (an abscess)
• Problems from the anesthetic. For example, some people are allergic to anesthetic. Tell your doctor if you have any allergies.

Sometimes, after a surgeon has removed someone's appendix, tests show that it was normal. Although surgery has some risks, there's a chance someone's appendix could burst if they don't get treatment. So most doctors think it's better to have the operation and be on the safe side. That's why surgeons sometimes end up removing a healthy appendix.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.