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Appendicitis

What is appendicitis and what are the signs and symptoms?

The appendix is a narrow, finger-shaped structure attached to the large intestine. While it serves no purpose in humans, it can cause serious problems when it becomes inflamed.  This inflammation, called appendicitis, is one of the most common surgical conditions seen in children. It occurs in all age groups and is particularly difficult to diagnose in children younger than 3 years of age.

The following is the typical progression of signs and symptoms of appendicitis; however, this can vary based on the age of the child and the location of the appendix:

• Abdominal Pain
  • This usually is the child's first complaint. The pain is usually felt first around the belly button or the middle part of the belly. After several hours as the infection worsens, the pain may intensify in the lower right side

• Fever
  • There may be a low-grade fever (100-101 degrees Fahrenheit; 38-38.5 degrees Celsius). 

• Loss of appetite: The absence of hunger occurs shortly after the onset of the pain.

• Vomiting
  • If vomiting occurs it is typically after the belly pain begins. This is an important clue in the diagnosis; however, vomiting can still occur before the belly pain with appendicitis.

• Other clues:
  • Pain on coughing or hopping on the right foot
  • The child typically prefers to lie still sometimes curled up in a fetal position
  • Appendicitis does not usually cause the frequent vomiting and diarrhea that is seen with the stomach flu.

 Are there complications from unrecognized appendicitis?

• Appendicitis can be life-threatening, particularly if the appendix ruptures. When the appendix first ruptures, a child's discomfort may suddenly disappear misleading you into thinking the child is improved. 

• After opening up, infection can spread to the rest of the abdomen, causing your child to become much more ill (i.e. very tender belly, high fever, very ill-appearing).

• Recovery may take much longer, and there may be more complications than with appendicitis diagnosed and treated earlier.

 How can appendicitis be diagnosed?

·         A careful history and physical examination can diagnose appendicitis in most cases. If the doctor is not certain the problem is appendicitis, additional laboratory or X-ray examinations may be performed to see if more conclusive signs develop.

What is the treatment for appendicitis?

·         If there is a strong probability that appendicitis is present, surgery usually will be done as soon as possible.

·         Intravenous fluid and antibiotics will be started as well.

When should I call my pediatrician concerning signs and symptoms of appendicitis in my child?

·         It is best to call your pediatrician for specific instructions when you first suspect that your child has signs and symptoms of appendicitis.  The earlier the diagnosis the better.