Introduction

Appendectomy is the surgical removal of the appendix, a small, tube-like structure attached to the large intestine. While the appendix was once thought to serve no significant purpose, modern research indicates it may play a minor role in the body’s immune function, particularly during early life. Nonetheless, the human body functions normally without it, and its removal becomes crucial in cases of infection, inflammation, or other related complications.

Appendectomy is most often performed in emergency situations when appendicitis is suspected. However, there are multiple causes of appendectomy surgery ranging from infections to tumors that may lead to the need for this surgery.

Causes of Appendectomy Surgery

Acute Appendicitis :- By far the most common cause of appendectomy is acute appendicitis. This condition arises when the appendix becomes inflamed, often due to a blockage in the appendiceal lumen. The blockage can result from hardened stool, intestinal parasites, swollen lymphoid tissue, or occasionally tumors. Once blocked, the appendix fills with bacteria and pus, leading to swelling, pain, and the risk of rupture. Symptoms typically include sudden pain in the lower right abdomen, nausea, vomiting, fever, and abdominal tenderness. Because of the high risk of complications like peritonitis or sepsis, appendectomy is urgently recommended when acute appendicitis is diagnosed.
Chronic Appendicitis :- Though significantly less common than acute appendicitis, chronic appendicitis also accounts for a portion of appendectomies. It involves long-standing or recurring inflammation of the appendix. Patients with chronic appendicitis may experience vague or intermittent abdominal pain over weeks or months. Unlike the acute form, symptoms are often less severe, making diagnosis more difficult. When persistent discomfort cannot be attributed to other causes and imaging suggests subtle inflammation, surgery may be performed as a definitive solution.
Appendiceal Abscess or Perforation :- If acute appendicitis is not treated promptly, it can progress to a perforation or rupture of the appendix. This leads to the formation of an abscess—a collection of pus around the appendix—or widespread infection within the abdominal cavity. In such cases, immediate surgery may not always be possible due to the extent of infection. Instead, the patient is initially treated with antibiotics and drainage, followed by an interval appendectomy once the infection subsides. This staged approach reduces surgical risks and prevents recurrence.
Appendiceal Tumors or Neoplasms :- In rare cases, tumors of the appendix may be discovered either during imaging or incidentally after removal. These tumors can be benign or malignant and include carcinoid tumors, adenocarcinoma, or mucinous cystadenoma. If such growths are found, appendectomy is essential not only to remove the appendix but also to prevent further spread. Depending on the tumor type and stage, additional surgical removal of adjacent bowel sections may be necessary. Tumors are among the less frequent but serious causes prompting an appendectomy.
Appendiceal Mucocele :- A mucocele is a condition where the appendix becomes distended due to a build-up of mucus, often from obstruction or a tumor. Though it may remain asymptomatic for some time, it can eventually cause abdominal discomfort or even rupture, spilling mucus into the abdomen—a condition known as pseudomyxoma peritonei. Once a mucocele is identified through imaging or during exploratory surgery, an appendectomy is typically recommended to prevent complications.
Foreign Bodies and Parasites :- Occasionally, foreign objects like seeds, pins, or undigested materials may find their way into the appendix and block its opening. Similarly, parasitic infections, especially with pinworms, can obstruct the appendix and cause inflammation. Although these causes are rare, when inflammation or infection results from such blockages, appendectomy becomes necessary to alleviate symptoms and avoid complications.
Appendicitis During Pregnancy :- Appendicitis is one of the most common non-obstetric surgical emergencies during pregnancy, especially in the second trimester. Diagnosis can be challenging due to the physiological changes in pregnancy, such as the displacement of the appendix by the growing uterus and the overlap of symptoms like nausea and abdominal discomfort. Despite these challenges, appendectomy surgery remains the standard treatment, as untreated appendicitis can pose severe risks to both the mother and the fetus.
Trauma to the Appendix :- Though uncommon, direct trauma to the abdomen from accidents, sports injuries, or blunt force can damage the appendix or trigger inflammation. In such situations, if signs of infection or swelling develop, surgical intervention may be necessary. Imaging and clinical evaluation help determine whether trauma has directly contributed to appendiceal inflammation.
Prophylactic (Preventive) Appendectomy :- In specific medical or surgical situations, an appendectomy Surgery may be performed even when the appendix appears normal. This preventive measure, known as prophylactic appendectomy, is sometimes undertaken during other abdominal surgeries, such as gynecological or colorectal procedures, to eliminate the future risk of appendicitis. It may also be performed in individuals who are expected to spend extended time in remote areas without access to emergency care—such as astronauts or military personnel. While not routine, it is considered a precaution in carefully selected cases.

Conclusion

Appendectomy Surgery is not only a life-saving procedure but also a necessary surgical solution for a variety of abdominal conditions. While acute appendicitis is the most common and well-known cause, other conditions like chronic inflammation, tumors, abscesses, mucocele, trauma, or even rare parasitic infections can also lead to the need for surgical removal of the appendix.

Understanding these causes helps patients and caregivers recognize the early signs of trouble and seek timely medical intervention. Thanks to modern diagnostics and advancements in surgical techniques—particularly minimally invasive laparoscopic approaches—appendectomy has become a safe and efficient procedure with excellent outcomes.

Prompt recognition and treatment of the underlying causes do more than remove a problematic organ—they prevent life-threatening complications and restore health quickly. If you or someone you know experiences symptoms suggestive of appendicitis, consulting a doctor immediately could make all the difference.