Appendicitis in Children

Parents are often surprised to learn that children can suffer from appendicitis.

What is appendicitis?

It is the inflammation (usually infection) of the appendix, which is a small extension or pouch of the large intestine. What is the role of the appendix? It is believed, just like the tonsils, that the appendix may be involved in the development of the immune system as a baby develops in the uterus.

What are the symptoms of appendicitis?

The classic symptoms of appendicitis in adults is acute (sudden onset) abdominal pain, typically, starting around the belly button area and then moving down to the right lower side of the abdomen. There can be nausea with or without vomiting, and there may be a low-grade fever. There are also some very specific findings that a doctor looks for when examining a person with suspected appendicitis, including very tender right lower abdomen, and pain in the same area with movement of the body (jumping up and down or even walking). There are really no specific tests to confirm the diagnosis. A blood test and regular X -Ray of the abdomen may or met not be helpful. More recently ultrasounds and CT scans have been found helpful in confirming appendicitis.

How is appendicitis confirmed?

The diagnosis is made based on an evaluation by a surgeon. If the surgeon strongly suspects appendicitis, then the treatment is to operate and remove the inflamed appendix. This is the only treatment of appendicitis, because if left untreated, the appendix will become so inflamed and swollen, that it will rupture. A ruptured appendix is quite serious and potentially life threatening; the material normally in the appendix, full of bacteria, spreads within the abdomen and can get into the blood. If this happens, aside from surgery, antibiotics are needed after the operation for a prolonged period to prevent spread of infection. Fortunately, in most cases, the appendix is removed before it ruptures, usually with a quick recovery and without the need for other treatments.

Appendicitis in children is difficult to diagnose

It is important to understand that abdominal pain in childhood is quite common, accounting for tens of thousands of doctor visits annually: But only a very small percentage of children with abdominal pain actually have appendicitis. However, when appendicitis occurs in children, it can present as described above, but can also reveal itself with very non-specific or non-typical symptoms. If the doctor or surgeon is not fully convinced that this is appendicitis, there are several options, depending on the individual situation: A physician may send the child home advising the parents to bring the child right back if the pain worsens or persists. Still in other cases, the child might be admitted to hospital for observation.