Appendicitis in kids is a serious condition where the appendix, a finger-shaped pouch that sticks out from the colon on the lower right side of the abdomen, becomes inflamed and swollen. The most common symptom is pain that begins around the belly button and then moves to the right lower part of the abdomen. Children may also experience vomiting and fever.
If you recognize symptoms of appendicitis in your child, make an appointment with a healthcare professional for evaluation. Doing so will reduce the risk of complications, including a ruptured appendix, and allows for a speedy recovery. Abdominal pain that does not go away or is severe requires immediate medical attention and you should go to the emergency room.
Symptoms of Appendicitis in Kids
Children and teenagers over the age of five are at greatest risk for developing appendicitis. It is rare for infants under the age of one to develop the condition, although it’s possible.
Symptoms can vary but may include:
- Abdominal pain that starts around the belly button and then moves to the lower right side of the abdomen
- Pain that worsens with movement or coughing
- Loss of appetite and refusal to eat, even their favorite foods
- Nausea and vomiting
- Fever. A low-grade fever may indicate early appendicitis where as a high fever can indicate late appendicitis or ruptured appendicitis
- Constipation or diarrhea
- Guarding or tensing the muscles of the abdomen out of fear of pain
Appendicitis pain can be constant or come and go. Pain often worsens and is persistent as the condition progresses, especially if the appendix ruptures.
What Causes Appendicitis in Kids?
Appendicitis is caused when the opening of the appendix into the colon (large intestine) is blocked. The two most common causes are stool (poop) and lymph nodes. When the opening is blocked, the appendix begins to fill with pus, mucus and stool. It will continue to swell and can eventually rupture (break open) if it is not treated in a timely manner.
When to Seek Medical Help
If your child is experiencing signs of appendicitis, visit a medical provider right away for help.
If left untreated, an infected appendix can potentially rupture. In these cases, appendicitis can spread harmful bacteria throughout the abdomen.
Appendicitis Complications
Possible complications of appendicitis may include:
Perforation: This is possibly life threatening, therefore it is important to remove the pus and eventually the appendix.
Abscess: A cavity of pus, as discussed above.
How is Appendicitis in Kids Treated?
Appendicitis can be treated one of three ways:
- Surgery (called appendectomy) with antibiotics
- Antibiotics alone
- Drainage and antibiotics with delayed surgery
There are certain situations where appendicitis cannot be treated with antibiotics alone and the surgeon will discuss this with you when discussing treatment.
Additionally, treating appendicitis with antibiotics alone does have a 30 percent risk of having recurrent appendicitis, with the need for surgical removal of the appendix.
If the appendix is ruptured with a well-formed abscess (cavity of pus), your child may require a drain placement and antibiotics. In these situations, we admit your child while the drain is in place and provide antibiotics. Once the drain stops draining, it is removed and your child is discharged, and we plan to remove the appendix 6-8 weeks later once the inflammation improves.
Surgical Removal of the Appendix: Appendectomy
During a Laparoscopic Appendectomy, a pediatric surgeon removes the infected appendix through small openings in the abdominal wall. They use cameras and instruments to remove the appendix where it attaches to the colon.
During an open appendectomy, pediatric surgeons use a larger incision to identify the appendix and remove the appendix where it attaches to the colon. Antibiotics may also be given to help manage the infection.
Discharge
After an appendectomy, watch for symptoms that you should return to the hospital for, including fever that does not get better with Tylenol or Motrin, abdominal pain that feels like appendicitis, and inability to pass gas or stool. Should these symptoms occur, return to the local emergency department for further evaluation.
Call the schedule a follow up appointment with your surgeon or their advanced practitioner team.
