Appendicitis

What is...

What is appendicitis?

Appendicitis is an inflammation of a part of the intestine called the appendix.

The appendix is a narrow, finger-shaped sac near where the small and large intestines come together. If the opening of this sac becomes blocked, the appendix can become red, swollen, irritated, and painful.

Bacteria then get trapped in the appendix and can infect the tissue in that area. If untreated, an inflamed appendix can burst open (rupture), spreading the infection into the abdominal cavity and bloodstream.

Appendicitis affects about 5% of the population (one in twenty people). Although it may occur at any age, appendicitis is most common in teenagers and young adults. It is the main reason for abdominal surgery in children.

Symptoms

Symptoms and signs of appendicitis

The symptoms of appendicitis in children and young people can be similar to those of other more common conditions, such as acute gastroenteritis (an infection of the intestines caused by bacteria or viruses), constipation, or trapped gas.

Appendicitis usually starts with slight fever (38.0 - 38.5ºC), loss of appetite, and pain near the bellybutton. The pain may come and go, but will gradually increase and eventually become constant.

After the onset of abdominal pain, nausea and sometimes vomiting may follow. Children may even have a little diarrhea, while others may experience the need to urinate more often.

After a few hours, the pain usually moves to the right side of the lower abdomen. This shift in the location of the pain signals that the inflammation may be spreading from the appendix to the abdominal cavity.

Complications

Complications of appendicitis

If the condition is not quickly diagnosed and treated, then the inflamed and blocked appendix may burst open, causing pus (infected fluid) to enter the abdominal cavity. This causes peritonitis, an inflammation of the lining of the abdominal cavity (peritoneum).

When the infection spreads to the peritoneum, the child will seem much more ill, with worse pain and higher fever. The child's stomach will be tense and painful even to touch. This can be a life-threatening situation for the child, who must be taken to the hospital for immediate surgery.

Home treatment

Treatment / What you should do if your child has appendicitis

The majority of children with abdominal pain do not have appendicitis, but if your child has symptoms that are suggestive of appendicitis, he or she should be seen by a doctor.

In order to help make the diagnosis, the doctor may order some tests, including blood tests and x-rays, although no test can diagnose appendicitis with complete accuracy. Sometimes, the diagnosis will remain uncertain and doctor will choose to admit the child to the hospital for observation.

You should not give pain medications to a child with abdominal pain before speaking with or having a doctor examine the child. Pain medication can disguise the child's symptoms and may allow the illness to develop further before being diagnosed.

If the child has appendicitis, surgery is necessary to remove the infected appendix. This is called an appendectomy. The appendix can be removed through traditional surgery, which involves a long incision into the abdomen, or using laparoscopic surgery, a less invasive technique that uses small instruments and a video camera inserted through several very tiny incisions.

In addition to surgery, the child will often need intravenous fluids, pain relief medication, and perhaps antibiotics. A child with uncomplicated appendicitis usually will go home from the hospital within 2-3 days. Longer stays are necessary when the appendix has burst open.

Prevention of appendicitis

It is impossible to prevent appendicitis.

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