Understanding the risks of appendicectomies: the hidden danger of retained faecoliths

Appendicitis, a condition where the appendix becomes inflamed, infected or perforated, is a medical emergency. The standard treatment is surgical removal of the appendix, a procedure known as an appendicectomy. While an appendicectomy is widely regarded common treatment, affecting approximately 10% of adults during their lifetime, it is not without risks, some of which are preventable.

The role of faecoliths in post-surgical complications

In around 30% of appendicectomy cases, a faecolith – a hardened, stony-like mass of compacted faeces – is present in the appendix. The removal of the appendix requires precision to avoid dislodging a faecolith which can cause serious complications. If a faecolith is inadvertently dislodged and spills into the abdominal cavity during surgery, it can cause severe health issues, including abscess formation and fistula development. A fistula is an abnormal connection joining two hollow spaces, often resulting in an abnormal flow of fluid from one space to the other. These complications can leave patients bedridden, in extreme pain and unable to work. In the absence of timely medical intervention, a retained faecolith can lead to chronic discharge from surgical ports and the need for further laparoscopic or open surgery to remove the faecolith and excise the fistula.

The legal implications of medical oversight

When a retained faecolith goes unnoticed or unmanaged, the consequences can extend beyond physical suffering. Patients who endure pain and suffering due to surgical errors may pursue legal action through a medical negligence claim. Negligence in this circumstance can include failing to identify or properly remove a faecolith, inadequate monitoring of patient scans, or neglecting appropriate follow up care once a faecolith has been identified post operatively. Medical negligence solicitors therefore place a key role in advocating for patients who have been let down by their healthcare providers.

Prevention: a shared responsibility

Preventing complications from a retained faecolith begins in the operating room. Surgeons must use meticulous techniques to ensure the appendix and any faecoliths are safely removed. For example:

• Placing the appendix in a retrieval bag before extractions;
• Removing the appendix through a laparoscopic port under direct camera guidance to prevent accidental spillage;
• Carefully inspecting the appendix post – removal to confirm no faecolith has been dislodged.

If a faecolith is identified in post – operative scanning, immediate action should be taken to remove it, provided any other injuries have been ruled out. Again, prompt intervention can prevent chronic abscesses, fistula development and the need for additional surgeries which can cause months, if not years, of unnecessary pain for the victims.

Educating and empowering patients

Patient education is also critical in mitigating risks of retained faecoliths.  Patients should be informed of the potential complications and the importance of proper follow – up care. Awareness enables patients to advocate for themselves, ensuring that any post – surgical issues are addressed promptly.

By emphasising the important of surgical precision and patient education, healthcare providers can help minimise the preventable risks, reducing the burden on both patients and the healthcare system. A proactive approach not only protects patients but also safeguards the reputation of the NHS, fostering a system where patient safety is paramount.

Contact our surgical negligence solicitors today