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Appendicitis in Children: How to Recognize and Treat It?

Appendicitis (referred to as the appendix in medical terms) is a part of the intestine that is attached to the small intestine, shaped like a worm with a small lumen diameter, and is typically located in the lower right side of the abdomen. The appendix plays a role in the immune system, especially in digestion. Appendicitis in children occurs in about 1 in 1,000 children in the United States, making it one of the conditions that requires immediate surgery in the pediatric population.

Appendicitis can occur due to various causes, most commonly due to a blockage in the appendix lumen, which can happen due to:

  • Swelling caused by infection (either viral or bacterial).

  • Blockage from hardened fecal matter in the intestine (feces) that obstructs the appendix lumen.

  • Other causes such as tumors or malignancies of the appendix itself.

Read more: Why Do My Gums Often Bleed When I Brush My Teeth?

How to Recognize Appendicitis in Children?

To recognize appendicitis, it is important to be aware of the early symptoms, which include:

  • Early Symptoms of Appendicitis:

    • Pain or discomfort around the navel.

    • Loss of appetite.

    • Changes in bowel movements:

      • Rare bowel movements or diarrhea (diarrhea is more common in children).

    • Nausea and vomiting.

    • Pain that later becomes localized to the lower right abdomen (characteristic of appendicitis).

    • Pain may also radiate to the right hip, depending on the position of the appendix in each individual.

    • High fever: Indicates the spread of infection to the bloodstream.

  • Important Warning:

    • If appendicitis is left untreated for 24-36 hours, the appendix may rupture.

    • When it ruptures, pain can spread throughout the abdomen due to the dispersion of pus.

What Should Be Done for Appendicitis?

If appendicitis is suspected, the following tests can be performed:

  • Laboratory Tests (Blood Tests):

    • Elevated white blood cell count (leukocytosis).

    • Increased levels of other inflammatory markers.

  • Radiological Tests:

    • Abdominal Ultrasound (USG): To detect the presence of appendicitis.

    • CT scan: Performed if symptoms are atypical or difficult to diagnose.

  • Clinical Examination:

    • If symptoms strongly suggest appendicitis, clinical examination should be prioritized, and other tests are only supportive.

Appendicitis can resemble other conditions, such as urinary tract infections, small bowel inflammation, or diverticulitis (pouching) of the small intestine.

Treatment of Appendicitis in Children

The treatment for appendicitis generally involves the administration of antibiotics and surgery.

  • Antibiotics:

    • Some new opinions suggest that antibiotic treatment can be effective, but the success of antibiotic treatment for appendicitis depends on the cause of appendicitis in children.

  • Surgical Treatment:

    • Open Appendectomy: The appendix is removed through an abdominal incision.

    • Laparoscopic Appendectomy: A minimally invasive procedure using a camera to view the abdominal cavity and remove the appendix with instruments inserted through small incisions. This method results in smaller incisions compared to open appendectomy.

  • Advantages and Disadvantages:

    • Each method has its advantages and disadvantages, and the technique chosen should depend on the surgeon’s preference.

  • Why Early Diagnosis Is Important:

    • Since appendicitis can cause complications very quickly, early recognition of the symptoms ensures that the surgery is simpler and carries lower risks.

 

 

Consultation at RS Hermina Podomoro

We understand your concern about your child’s health. RS Hermina Podomoro has a team of experienced pediatric surgeons who specialize in handling various surgical cases in infants and children, including congenital gastrointestinal disorders. To schedule a consultation, you can contact us via:

 

 

References:

All You Need To Know About Appendicitis. Pediatric Surgical Associates. Available at: https://www.pedsurgical.com/need-know-appendicitis/. Accessed on June 29th, 2024.

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