Appendicitis affects approximately 70,000 children in the US each year. It is the most common cause of emergency abdominal surgery in children. This condition is easily treatable with surgery, but getting timely treatment is vital. Without treatment, appendicitis in children can lead to an infected and ruptured appendix, which is a life-threatening condition. This article will talk about some of the common symptoms of appendicitis in children to help you recognize it early.

What is appendicitis?

The appendix is a small finger-like pouch that extends from the large intestine. It is located in the lower right part of the abdomen. The appendix does not serve any important function.

Appendicitis is a condition in which the appendix becomes inflamed, causing abdominal pain. The pain can start around the umbilicus (naval) and then move to the lower right abdomen. As the inflammation becomes worse, the abdominal pain becomes severe.

What age can a child get appendicitis?

Anyone can develop appendicitis, including children. This condition commonly occurs in people between the ages of 10 and 30, and is most common among teenagers and young adults in their early 20s. 

In children, the peak incidence of appendicitis is between the ages of 12 and 18 years. Boys develop appendicitis more frequently than girls. 

Appendicitis in younger children is relatively uncommon. However, when it does develop in children younger than 4 years of age, there is a high risk of rupture, and the child may require emergency surgery.

How do I know if my child has appendicitis?

The first signs of an inflamed and infected appendix are usually abdominal pain around the belly button and a mild fever. Consequently, appendicitis in children might seem like a regular stomach ache. However, when a child’s appendix is inflamed, the pain keeps getting worse and moves to the lower right side of the belly.

If your child is complaining of belly pain, look out for these signs of appendicitis: 

• Severe pain around the belly button or in the right lower part of the belly 
• Pain that comes and goes initially but then worsens and becomes steady and intense
• Low-grade fever
• Nausea and vomiting
• Loss of appetite
• Diarrhea
• Swollen belly

In young children who may not be able to describe their symptoms, look out for signs such as: 

• Lying on their side with knees drawn up
• Walking bent over at the waist
• Vomiting
• Tenderness to touch (the child will not allow you to touch their belly)

You should not rely on your own assessment of your child’s symptoms. It’s important to have appendicitis diagnosed promptly by your child’s healthcare provider. If you do not get your child’s appendicitis treated in time, it can lead to severe complications. 

In children, treatment for appendicitis is usually surgical removal of the inflamed and irritated appendix.

How do you check for appendicitis at home?

Sharp stomach pain can be caused by various things, such as gas that requires no treatment to acute appendicitis, a potentially life-threatening medical emergency. Knowing how to recognize appendicitis is therefore important.

• The telltale sign of appendicitis is a sudden, sharp pain near the belly button or in the right lower abdomen.
• Appendicitis pain gets worse over time. Call your doctor if you are still in pain despite taking pain medicines.
• Stomach pain in appendicitis is typically worse with moving, sneezing, or coughing.
• Other symptoms of appendicitis are usually present, such as low-grade fever, painful swelling in the abdomen, nausea, vomiting, diarrhea, abdominal bloating, and loss of appetite.

How is appendicitis diagnosed?

Healthcare providers diagnose appendicitis in children and adults by performing a physical exam and ordering specific tests. An examination allows the doctor to check for signs of appendicitis, such as the location of the pain and guarding (stiffening of the abdominal muscles in response to pressure). 

Your child’s doctor may order blood tests to check if there is a high white blood cell count, which indicates an infection. They may order urine tests to rule out kidney infection. 

The confirmatory test for appendicitis is an imaging study such as an abdominal X-ray, ultrasound, CT scan, or MRI, which can show whether your child’s appendix is inflamed and infected.

What happens if an infected and ruptured appendix is left untreated?

Pediatric appendicitis is a serious condition that requires immediate medical attention. If it is not treated, your child’s appendix can rupture (burst open). It can take 48 to 72 hours after your child develops appendicitis symptoms before the appendix ruptures. However, appendix rupture can occur sooner in some cases.

A ruptured appendix can spread bacteria throughout your child’s abdomen and lead to a widespread bacterial infection called peritonitis that involves other abdominal organs. It can also lead to a severe infection of the bloodstream called sepsis. 

What are the signs of a ruptured appendix?

A ruptured appendix is a medical emergency. Symptoms of a ruptured appendix may include: 

• Widespread pain and tenderness throughout the abdomen
• Abdominal pain that is worse with touch or movement
• Pain that worsens with each passing hour
• Bloating
• Gas
• Nausea 
• Diarrhea or constipation
• Fever
• Chills

Note that these signs and symptoms may not appear immediately after the appendix ruptures. Your child may initially feel better because the rupture will relieve some pressure. However, once bacteria spills into the abdominal cavity, it will cause infection, inflammation, and the worsening symptoms mentioned above.

How do doctors treat appendicitis in children?

The standard treatment for appendicitis in children and adults is surgery to remove the appendix. However, sometimes mild appendicitis may be treated with antibiotics alone. 

Surgery for Appendicitis in Children

The surgery for removal of the appendix is called an appendectomy. It takes about an hour to perform. An appendectomy can be performed through laparoscopic surgery, which is done through small incisions in the abdomen. This minimally invasive approach is associated with a shorter recovery time and a lower risk of infection. 

Sometimes, an open laparotomy may be necessary to remove the appendix in complicated cases. This surgery involves a larger incision in the lower right part of the abdomen and requires a longer recovery time.

Recovery After Appendectomy

If it is a simple case of acute appendicitis, your child may be able to go home after an overnight stay in the hospital. Some children can go home later the same day after surgery. 

In more complicated cases of perforated appendicitis where the appendix has burst, your child may need to stay in the hospital longer (approximately 5 days). Doctors will give intravenous (IV) antibiotics to treat or prevent severe abdominal pain infection. 

Life After Appendectomy

There are no long-term sequelae after your child has their appendix removed. Most children recover quickly after appendectomy. Your child’s surgeon may recommend limiting physical activity for a few days after surgery, but other than this, no long-term lifestyle changes or dietary modifications are necessary. 

Wrapping Up

Appendicitis in children and adults is a serious and potentially deadly infection. It can, however, be easily managed if recognized and treated in time.

If you suspect appendicitis, go to the nearest emergency room or contact your child’s healthcare provider for an accurate diagnosis and treatment. 

Reference:

1. https://www.sages.org/wiki/pediatric-appendicitis/
2. https://www.mayoclinic.org/diseases-conditions/appendicitis/symptoms-causes/syc-20369543
3. https://my.clevelandclinic.org/health/diseases/10792-appendicitis-in-children