The appendix is a small structure that is attached to the large intestine and serves an unknown purpose. It can easily become inflamed, usually after a piece of stool or food is trapped inside. Once inflamed, the appendix will swell, become infected and cause pain.
Most parents are familiar with the symptoms of appendicitis, especially the severe pain in the right lower side of a child's abdomen, but many parents still worry about appendicitis whenever their kids have belly pain, even if they don't have classic symptoms.
Having a good understanding of this common problem can help to avoid unnecessary visits to the emergency room and avoid a delay in diagnosis or a misdiagnosis when your child really does have appendicitis.
Because appendicitis is considered to be a surgical emergency, if you think your child has appendicitis, call your doctor or go to the emergency room right away.
What are the classic symptoms of appendicitis?
The symptoms of appendicitis usually include:
- pain in the right side of the abdomen
- inability to pass gas
- low fever that begins after other symptoms
- abdominal swelling
- anorexia (loss of appetite)
Although people often think of the pain being in the lower right side of the abdomen when a child has appendicitis, it is important to realize that the pain usually starts in the middle of the abdomen, near the belly button (periumbilical). The pain then quickly worsens and moves to the lower right side (McBurney's point).
And there are many illnesses that cause abdominal pain and vomiting, like a simple stomach virus, but unlike these other conditions, with appendicitis, the child usually has pain first and then begins vomiting afterwards.
Keep in mind that younger children with appendicitis may not have classic symptoms, which leads to a higher rate of misdiagnosis in that age group. These children might have other complaints, like hip pain or refusing to walk and vomiting may be the first symptom that parents report.
Untreated, an inflammed appendix may burst or perforate, with the child getting sicker and having a higher fever.
Who gets appendicitis?
Appendicitis is most common in older children and young adults and mainly affect people between the ages of 10 and 30.
Although the incidence of appendicitis is low for children under age 5 years, it begins rising in school age children and reaches its peak during the teen years.
Remember that you can get appendicitis at almost any age though.
Tests for Appendicitis
Routine tests usually include a white blood cell count and a urinalysis.
In children with classic symptoms, that may be all the testing that is necessary before the child goes to surgery to have the appendix removed (appendectomy).
If the doctor is still unsure if a child has appendicitis or not, further tests might include either an ultrasound or an abdominal CT scan.
Treatments for Appendicitis
The initial management or treatment for a child with appendicitis, along with consulting a surgeon, usually includes making sure that the child doesn't have anything to eat or drink (NPO), starting intravenous fluid and antibiotics.
The definitive treatment is a laparoscopic or open appendectomy, in which the inflammed appendix is removed.
Don't We Need Our Appendix?
The appendix serves no known purpose and your child will live normally once it is removed.