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Home Health Kids Appendicitis in Children

Appendicitis in Children

Surprisingly, in 2005 appendicitis was the third leading cause of hospitalizations in children in Anne Arundel county. Not every abdominal pain is appendicitis, but it’s clearly important to understand when stomach pain signals trouble. 

According to the National Institutes of Health’s National Digestive Diseases Information Clearinghouse, appendicitis is the main reason, nationwide, for emergency abdominal surgeries. Appendicitis happens when your appendix becomes infected, and it’s most common in people aged 10 to 30. The appendix is a tiny, finger-shaped pouch attached to your large intestine on the lower right side of the tummy, and it appears to have no useful function.

Infection can occur when bacteria becomes trapped in the appendix, either due to something keeping it inside the appendix — a hard stool or enlarged lymph node can block the opening. The appendix can become irritated and inflamed. Infection will cause intense pain and, if left untreated, the appendix can rupture (also known as perforate). There is no way to predict who will get an appendicitis or when. Some of the symptoms in children include abdominal pain, fever, nausea, vomiting, inability to pass gas, constipation or diarrhea, abdominal swelling, and a poor appetite. Proper diagnosis is made based on symptoms and a doctors exam, which will usually include an ultrasound and a type of x-ray known as a CT scan.

Treatment is pretty straightforward. If the infected appendix is still intact (not ruptured), then the child is admitted to the hospital, given antibiotics, intravenous (IV) fluids, and the appendix is removed through a very small incision in their abdomen. Some hospitals now remove the appendix through a procedure employing small telescopes and instruments called larparoscopy. 

If the appendix has burst, then IV antibiotics will be given immediately upon hospital admission. It’s more important to control the infection first than to intervene surgically at this point. Surgery to remove the appendix may be delayed until the infection is healed; this is called an interval appendectomy. Ruptured appendicitis can cause complications with surgical wound healing, or a pus-filled abscess can develop at the rupture site. Either of these complications mean the child will need to go under general anesthesia to clean the wound or drain the pus.

The hospital stay may be for a few days or weeks after receiving antibiotics. Before going home, he or she should be able to drink, be comfortable on their pain medication, be infection-free, and without a fever. Full recovery can take about 4 to 6 weeks, and unfortunately, their physical activity will need to be curtailed so the tissues can fully heal.

As always, every child is different and every case is different. Check with your physician immediately, or go to the E.R., if your child has the above symptoms.

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