How does appendicitis present in children. What are the warning signs parents should watch for. When should you seek medical attention for suspected appendicitis in a child. What does the diagnosis and treatment process involve.

Understanding Appendicitis in Children: A Common Pediatric Emergency

Appendicitis is a serious medical condition that affects thousands of children in the United States each year. This potentially life-threatening condition occurs when the appendix, a small tube-like structure connected to the large intestine, becomes infected and inflamed. While appendicitis can affect people of all ages, it presents unique challenges in pediatric patients, particularly in very young children.

In the U.S. alone, appendicitis results in approximately 77,000 pediatric hospitalizations annually. Alarmingly, about one-third of these cases involve a ruptured appendix before surgical intervention can take place. This statistic underscores the critical importance of early recognition and prompt medical attention.

The Prevalence of Appendicitis in Different Age Groups

Appendicitis shows varying prevalence across different age groups:

• Rare in infants
• More common after age 10
• Most prevalent in teenagers and young adults in their early 20s
• After age 15, boys are twice as likely to be affected as girls

Children with a family history of appendicitis may be at an increased risk. However, it’s crucial to note that children under 4 years old face the highest risk of experiencing a ruptured appendix. This elevated risk is partly due to the atypical presentation of symptoms in very young children, making timely diagnosis challenging.

Recognizing the Warning Signs: Appendicitis Symptoms in Children

Identifying appendicitis in children can be tricky, as their symptoms often differ from those observed in adults. Moreover, these symptoms can mimic other medical conditions, further complicating the diagnostic process. However, being aware of the potential warning signs can help parents seek timely medical intervention.

Common Symptoms of Appendicitis in Children

While symptoms may vary, some of the most frequent indicators of appendicitis in children include:

• Mild to low-grade fever
• Abdominal pain, often starting around the navel and later migrating to the lower right abdomen
• A sensation of pressure or fullness in the belly
• Fluctuating abdominal pain that eventually becomes intense and constant
• Loss of appetite
• Nausea and vomiting
• Constipation
• Gas pain
• Small amounts of diarrhea, possibly containing mucus

Is abdominal pain always indicative of appendicitis in children. While abdominal pain is one of the most common symptoms of appendicitis, it’s important to note that belly pain can be caused by numerous other issues. The location, intensity, and progression of the pain, along with other accompanying symptoms, help differentiate appendicitis from other conditions.

When to Seek Medical Attention: Recognizing Urgent Situations

Given the potential severity of appendicitis, it’s crucial for parents to err on the side of caution. If you have any concerns about your child’s symptoms, it’s advisable to contact your pediatrician promptly. However, certain situations warrant immediate medical attention.

Red Flags: When to Rush to the Emergency Room

Seek immediate medical care if your child develops:

• A high fever (104°F or higher)
• Worsening abdominal pain, especially if it localizes to the lower right side
• Severe, persistent vomiting
• Signs of dehydration
• Extreme lethargy or unresponsiveness

These symptoms could indicate a ruptured appendix, which is a medical emergency requiring urgent intervention.

The Diagnostic Process: How Doctors Identify Appendicitis in Children

When a child presents with symptoms suggestive of appendicitis, healthcare providers employ a systematic approach to confirm the diagnosis. This process typically involves a combination of physical examination and diagnostic tests.

The Importance of Physical Examination

The physical examination is a crucial component of the diagnostic process. During this exam, the doctor will:

• Palpate the abdomen to check for tenderness and guarding
• Assess for rebound tenderness, a key sign of peritoneal irritation
• Check for fever and other vital signs
• Evaluate the child’s overall appearance and level of discomfort

Diagnostic Tests for Suspected Appendicitis

If the physical examination suggests appendicitis, the doctor may order additional tests to confirm the diagnosis:

1. Blood tests: To check for elevated white blood cell count, indicative of infection
2. Urinalysis: To rule out urinary tract infections
3. Imaging studies:
   • Abdominal X-rays: To visualize potential obstructions or free air in the abdomen
   • Ultrasound: A non-invasive method to visualize the appendix and surrounding structures
   • CT scan: Provides detailed images of the abdomen and can help confirm the diagnosis in ambiguous cases

Why might doctors delay scheduling an appendectomy even if appendicitis is suspected. Appendicitis can be challenging to diagnose definitively, especially in its early stages. In some cases, doctors may choose to observe the progression of symptoms before recommending surgery. This approach helps avoid unnecessary procedures while ensuring that children who truly need surgery receive it promptly.

Treatment Options: Managing Appendicitis in Pediatric Patients

Once appendicitis is confirmed, prompt treatment is essential to prevent complications. The primary treatment for appendicitis is surgical removal of the infected appendix, known as an appendectomy.

The Appendectomy Procedure

An appendectomy typically involves the following steps:

1. Administration of general anesthesia
2. Laparoscopic approach: The surgeon makes small incisions in the abdomen
3. Insertion of a laparoscope (a thin tube with a camera) to visualize the appendix
4. Removal of the infected appendix through one of the small incisions
5. Closure of the incisions with dissolvable sutures or surgical glue

In some cases, particularly if the appendix has ruptured, a traditional open surgery may be necessary.

Post-operative Care and Recovery

Following an appendectomy, children typically:

• Remain in the hospital for at least two days
• Receive intravenous antibiotics to prevent infection
• Are monitored for complications and pain management
• Begin a gradual return to normal activities over several weeks

Children who experience a ruptured appendix before surgery may require a longer hospital stay and more extensive antibiotic treatment.

Understanding the Risks: Complications of Untreated Appendicitis

Appendicitis is a progressive condition that can lead to severe complications if left untreated. The most significant risk is rupture of the appendix, which typically occurs within 48-72 hours after the onset of symptoms.

The Dangers of a Ruptured Appendix

When an infected appendix ruptures, it can lead to:

• Peritonitis: A serious infection of the abdominal cavity
• Abscess formation: Pockets of infection in the abdomen
• Sepsis: A life-threatening systemic infection
• Prolonged hospitalization and recovery time
• Increased risk of complications during and after surgery

These complications underscore the importance of early diagnosis and treatment of appendicitis in children.

Prevention and Awareness: Empowering Parents in the Face of Appendicitis

While there’s no known way to prevent appendicitis, parents can play a crucial role in ensuring prompt diagnosis and treatment. By being aware of the signs and symptoms, and seeking medical attention when needed, parents can help minimize the risk of complications.

Key Takeaways for Parents

• Familiarize yourself with the symptoms of appendicitis in children
• Don’t hesitate to contact your pediatrician if you suspect appendicitis
• Seek immediate medical care for severe abdominal pain or high fever
• Avoid giving your child food, drink, or medication without medical advice if appendicitis is suspected
• Be prepared to provide a detailed history of your child’s symptoms to healthcare providers

By staying informed and vigilant, parents can contribute significantly to the early detection and successful treatment of appendicitis in their children.

Advances in Pediatric Appendicitis Management: Current Research and Future Directions

The field of pediatric appendicitis management continues to evolve, with ongoing research aimed at improving diagnosis, treatment, and outcomes for young patients. Recent advances and areas of active investigation include:

Diagnostic Innovations

Researchers are exploring new diagnostic tools and techniques to enhance the accuracy and speed of appendicitis diagnosis in children. Some promising areas include:

• Biomarker research: Identifying specific blood or urine markers that could indicate appendicitis
• Advanced imaging techniques: Developing more precise, radiation-free imaging methods
• Artificial intelligence: Using machine learning algorithms to assist in interpreting diagnostic tests and predicting outcomes

Non-operative Management

While surgery remains the gold standard for treating appendicitis, there’s growing interest in non-operative management for select cases. This approach typically involves:

• Antibiotic therapy as the primary treatment
• Close monitoring for signs of improvement or deterioration
• Reserving surgery for cases that fail to respond to antibiotics

Early studies suggest that this approach may be viable for some children with uncomplicated appendicitis, potentially reducing the need for surgery and its associated risks.

Minimally Invasive Surgical Techniques

Advancements in surgical technology continue to make appendectomies less invasive and more precise. Emerging techniques include:

• Single-incision laparoscopic surgery (SILS): Performing the entire procedure through a single small incision
• Robotic-assisted surgery: Using robotic systems to enhance surgical precision and control
• Natural orifice transluminal endoscopic surgery (NOTES): Exploring the potential for appendix removal without external incisions

These innovative approaches aim to reduce surgical trauma, minimize scarring, and potentially speed up recovery times for pediatric patients.

Post-operative Care Protocols

Research is also focusing on optimizing post-operative care to enhance recovery and reduce complications. Areas of investigation include:

• Enhanced recovery after surgery (ERAS) protocols tailored for pediatric appendicitis patients
• Pain management strategies that minimize opioid use
• Early mobilization and feeding protocols to speed up recovery
• Infection prevention measures to reduce post-operative complications

How might these advances in appendicitis management impact pediatric patients in the future. As research progresses, we can anticipate more accurate diagnoses, less invasive treatments, and improved outcomes for children with appendicitis. These advancements have the potential to reduce hospital stays, minimize complications, and enhance the overall experience for young patients and their families.

While significant progress has been made in understanding and treating pediatric appendicitis, ongoing research continues to refine and improve care strategies. Parents and healthcare providers alike can look forward to increasingly sophisticated and patient-friendly approaches to managing this common childhood condition in the years to come.

How to know if your child is having appendicitis

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September 22, 2021
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by Edward-Elmhurst Health

Categories: Healthy Driven Moms

Each year, appendicitis sends 77,000 children in the U.S. to the hospital. About one-third of them experience a ruptured appendix, a life-threatening complication, before they reach the operating room.

Appendicitis is an emergency. Parents need to know what to look for so they can get medical care right away.

Below, get answers to commonly asked questions from parents:

Q: What is appendicitis?

A: The appendix is a small finger-shaped tube (with no known function) connected to the large intestine and located in the lower right side of the belly. If the appendix gets infected, it’s called appendicitis, which is a surgical emergency that requires prompt diagnosis and treatment.

Appendicitis is rare in infants, more common after age 10, and most common in teens and young adults in their early 20s. After age 15, twice as many boys are affected as girls. Children with a family history of appendicitis may be at greater risk. Children younger than age 4 are at the highest risk for a ruptured appendix, partly because young children don’t have classic symptoms, so diagnosis is easy to miss.

Q: What are the warning signs of appendicitis in children?

A: Children with appendicitis, especially very young children, tend to have different symptoms than adults, making it challenging to diagnose. Also, appendicitis symptoms can be similar to other medical problems so it can be tricky to tell the difference.

One of the most common symptoms of appendicitis in children is abdominal pain. However, belly pain can be caused by many other issues.

Some specific warning signs of appendicitis in children include:

• Mild/low-grade fever
• Belly pain (around the belly button, then may spread to the lower right belly)
• A feeling of pressure/fullness in the belly
• Pain in the belly may come and go at first, then grow intense and steady
• Loss of appetite
• Nausea, vomiting
• Constipation
• Gas pain
• Diarrhea (small amounts with mucus)

If you have any concerns at all, call your child’s doctor. If your child develops a high fever (104°F) and/or if belly pain gets worse and moves to the lower right side, get immediate medical attention as it could mean a ruptured appendix.

Q: What should I do if I think my child is having appendicitis?

A: If you suspect appendicitis, call your child’s doctor right away for next steps. You may need to have your child examined by their primary doctor, or the doctor may refer you to an Immediate Care Center or the Emergency Department. Don’t offer your child anything to eat or to drink and only give medications that are recommended by your primary doctor. This is important in case surgery is needed.

When you get to the ER, the doctor will likely perform a physical exam. This exam is the most important part of what your child needs. Abdominal pain is part of many benign everyday illnesses that do not require tests or surgery. If the doctor suspects appendicitis is part of the differential diagnosis, he/she will recommend a variety of tests, such as: blood work (to check white blood cell count), a urine test (to rule out a urinary tract infection), X-rays, ultrasound, CT scan and/or other tests. Appendicitis can be difficult to diagnose so your child’s doctor may wait to schedule an appendectomy until symptoms have progressed.

Q: What does an appendectomy involve?

A: An appendectomy involves surgically removing the infected appendix. The surgeon will typically use a laparoscope to remove the appendix through a small cut on the belly. Your child will probably need to stay in the hospital for at least two days. A child with a ruptured appendix might need to stay in the hospital longer. Your child will likely receive antibiotics to kill any bacteria that spread into the body.

Q: What makes the appendix burst? Is there any way to prevent it?

A: When the appendix gets blocked, bacteria can grow and cause an infection. Some things that might block the appendix are hard stool, swollen lymph nodes in the intestines, parasites and other infections. An infected appendix must be treated in the hospital with antibiotics and surgery. If it isn’t, the appendix can burst about 48-72 hours after symptoms first start. A ruptured appendix can spread bacteria inside the abdomen, which is serious.

There is no way to prevent appendicitis. The most important thing for parents to remember is to get your child the right medical care quickly.

Some ways for children to maintain gastrointestinal health include:

• Eating a high-fiber diet.
• Having regular meal times.
• Drinking plenty of water (at least 8 cups a day).
• Getting regular exercise.
• Chewing food slowly and thoroughly before swallowing.
• Not smoking.
• Not holding bowel movements or straining during them.

Learn more about Jennifer McNulty, M.D., pediatric emergency medicine physician and System Medical Director, Pediatrics for Edward-Elmhurst Health.

Open around the clock, Edward-Elmhurst Health’s fully-equipped kid-friendly Emergency Departments (EDs) in Naperville and Elmhurst, and a freestanding emergency center in Plainfield, provide specialized emergency care focused on the unique needs of children.

Learn more about our pediatric emergency care and check our ED wait times.

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How to Identify the Signs of Appendicitis in Kids

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

Appendicitis in a child: a brief guide for parents

Home / News / Appendix in a child: a brief guide for parents

Appendicitis in a child: a brief guide for parents. Evgeny Mikhailovich Petrov, a pediatric surgeon, a doctor of the highest category, head of the pediatric surgical department No. 1 of the Ivano-Matreninsky Children’s Clinical Hospital, tells about the first symptoms, diagnosis and the need for timely surgical treatment.

Acute appendicitis is one of the most common abdominal diseases in children that requires surgical treatment. The main symptom of appendicitis is persistent abdominal pain.

The clinical manifestations of the disease are varied: in older children, who can already assess the nature of their pain, the symptoms are more definite, in the younger children the clinic is not so clear, the disease may be accompanied by a rise in temperature to high numbers, general malaise, vomiting and loose stools . In addition, the anatomical location of the appendix in the child’s body can be different, which also affects the symptoms of appendicitis, which in some cases can “simulate” various somatic or infectious diseases.

– Usually six hours of continuous abdominal pain allows the surgeon to make a diagnosis of appendicitis. By this time, changes are already appearing in the appendix that can be seen on ultrasound, – says Evgeny Mikhailovich. – Ultrasound in this case is a fairly informative research method, with its help, the diagnosis of appendicitis in our hospital is confirmed in 70% of cases.

– The younger the child, the more difficult it is to make a diagnosis. But if the baby cries for a long time and worries when touching the stomach, then a surgeon’s consultation is definitely needed to rule out appendicitis, Evgeny Mikhailovich is sure. – This is the case when it is better to think about the disease and exclude it than to choose a wait and see approach.

There are cases when parents, wanting to help their child get rid of abdominal pain, gave him antibiotics, painkillers, lowered the temperature on their own, which led to “lubrication” of the appendicitis clinic and, as a result, late seeking medical help.

– You should refrain from taking any pills – at least until acute appendicitis is ruled out, – Evgeny Mikhailovich advises.

Treatment of appendicitis can only be surgical, it must be operated on early, ideally within the first 12 hours from the onset of the disease. The later the child enters the hospital, the worse the result of treatment and the prognosis for recovery: the treatment time for complicated appendicitis – peritonitis – is several times longer. Such patients after surgery may stay in the intensive care unit for a long time. In addition, in this case, massive antibiotic therapy is required, which is not very useful for the child’s body.

This is especially important for girls – after childhood peritonitis, secondary infertility may develop in adulthood: the adhesive process can affect the pelvic organs.

– More than 400 appendectomies are performed every year in our hospital, says Evgeny Mikhailovich. – Most of the children arrive early from the onset of the disease, which allows the child to be operated on time, discharged early and achieve a quick and complete recovery. Approximately 15% of patients with appendicitis present late, already with peritonitis. Basically, these are children from the suburbs of Irkutsk and remote areas of the Irkutsk region, but there are also urban patients among them. Some parents are afraid to go to the hospital because of the “danger” of the coronavirus, a number of parents are not sufficiently informed about the mode of our work. I remind you that all emergency services of our clinic work around the clock without holidays and weekends.

In the Ivano-Matreninsky hospital, patients with appendicitis are predominantly performed laparoscopic appendectomy – this is an operation without large incisions, through 3 punctures in the abdominal wall. This method of treatment can be used even in some cases of peritonitis.

– The main success in the treatment of appendicitis is its early detection and timely treatment, – sums up Evgeny Mikhailovich.

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symptoms, causes and effective treatments

When to see a doctor?, Symptoms and treatment

Many have heard of such a disease as appendicitis . This pathology can occur not only in adults, but also in children. What is this disease?

Appendicitis ¾ inflammation of the appendix (vermiform appendix), which is a closed part of the caecum; is located in the lower abdomen on the right. Appendicitis in a child occurs when the outlet of the appendix to the large intestine is blocked and inflamed. At the same time, many bacteria multiply that affect the appendix. With severe blockage, massive inflammation develops, and the wall of the appendix can die, resulting in its rupture.

Author: Assistant of the Department of Pediatrics №1 Sadova Olga

A sign of appendicitis in a child may be acute pain in the abdomen. But other symptoms also occur, which may differ depending on the age of the baby.

If appendicitis is suspected in a child, it is important to consult a doctor, because it is one of the most common diseases in children and requires urgent treatment. The disease in childhood is very dangerous, since the inflammatory process occurs faster than in adults, and can spread to other organs of the abdominal cavity. Only a doctor knows how to determine appendicitis in a child without confusing it with other inflammations, and start treatment as soon as possible.

Symptoms of appendicitis in babies

More often this disease occurs in children of school age. But still, cases of inflammation of the appendix in infants are described. Appendicitis in young children is not always possible to detect on time due to the peculiarities of the structure of the intestine at this age and the immaturity of the nervous system. Since there is a high risk of complications, it is very important to suspect appendicitis in a baby under 1 year old in a timely manner and provide assistance.

At this age, appendicitis in a child has very non-specific symptoms. Therefore, you need to pay attention if the baby curls up, presses the legs to the stomach, and when you try to change the position, it becomes restless. Facial expression may indicate a feeling of lingering pain. To find out how appendicitis hurts in children under one year old, you should feel the stomach. With such an attempt, the child will show great anxiety.

Signs of appendicitis in children from 1 to 3 years old

Parents should suspect appendicitis in a child of 3 years of age if he has:

• behavioral disorders: general weakness, drowsiness, capriciousness;
• nausea and/or vomiting;
• pale skin;
• appendicitis in children under 3 years of age may also be manifested by thirst, dry mouth;
• high body temperature, chills;
• constipation or loose stools.

Acute appendicitis in children under 3 years of age often begins to manifest similar, fairly common symptoms. Therefore, if the baby has even some of them, you should immediately contact a specialist. It is important to remember what the baby ate and when, whether there was vomiting, what kind of stool. Of course, these signs may indicate not only appendicitis in children, symptoms of a similar nature may be manifestations of another disease. Seeing a doctor is mandatory, even if it turns out that it is not appendicitis that manifests itself, in a child of 2 years of age or a little older, the doctor will be able to diagnose the cause and prescribe treatment.

Appendicitis in children after 5 years of age and schoolchildren

Appendicitis in children under 5 years of age may present with the following symptoms:

• high body temperature, chills;
• nausea, single vomiting;
• dry, white-coated tongue;
• lack of appetite;
• stool disorders (constipation, rarely ¾ diarrhea).

Based on these signs, you can suspect appendicitis in a child aged 5 years and consult a doctor 2-3 hours after the onset of the attack.

In school-age children, the signs of appendicitis are almost the same as in adults. The stomach starts to hurt, the temperature rises, nausea occurs, vomiting is possible. Often, if appendicitis occurs, symptoms in children 5 years of age and older are atypical. For example, the appendix may be located elsewhere. If it is covered by the liver or another organ, pain may occur in the back, lower abdomen.

Causes of appendicitis in children

Today, despite the development of medicine, it is not known exactly what causes appendicitis in children. But in order for the appendix to become inflamed, a blockage of its lumen must occur, and bacteria must develop in the intestine. Appendicitis occurs with the simultaneous presence of these conditions. For appendicitis to appear in children, the causes must be related to its blockage.

There are several factors contributing to the onset of the disease:

• Reduced immunity. In this case, the child’s body cannot cope with the pathogenic microflora, and the infection enters the abdominal cavity and intestines. There is inflammation.
• Individual features of the structure of the appendix ¾ the presence of twists, bends.
• Ingestion of foreign bodies, such as berry or fish bones, unpeeled seeds. They clog the lumen of the process, contributing to inflammation. The same situation can occur due to blockage of the appendix with helminths or feces.
• Frequent SARS, colds, sinusitis, otitis media weaken the body and immunity. Therefore, it is difficult for him to cope with the penetrated pathogens. In such cases, a severe form of appendicitis may occur with various complications.

Forms of appendicitis

Appendicitis can be acute or chronic. The acute form is characterized by sudden onset and rapid progression of symptoms. Chronic appendicitis in children is very rare. But if this happens, then pain and discomfort in the abdomen can bother the child for several months.

Acute appendicitis in children is of the following types:

• Catarrhal or simple ¾ in this case, there is a slight thickening of the walls of the appendix.
• Phlegmonous ¾ appendix increases in size, the blood that circulates in nearby vessels thickens, blood clots form in them.
• Destructive gangrenous appendicitis in children ¾ occurs necrosis of the tissues that form the walls of the appendix.
• Rupture or holes in the organ of the appendix are the most dangerous, as in this case, its contents enter the abdominal cavity. There is inflammation of the peritoneum (peritonitis), poisoning with toxic substances of the body and disruption of the functioning of many organs.

How far the process has progressed is indicated by the coating on the tongue. The larger its area, the more pronounced the inflammation. In the catarrhal form, a white coating is found on the root, in more complex cases ¾ throughout the tongue.

First aid: Parenting guide

If a child is suspected of having appendicitis, parents should take the child to the doctor as soon as possible to confirm the diagnosis.

Often appendicitis can be disguised as other pathologies, such as bronchopneumonia, hepatitis, acute intestinal diseases (gastroenteritis, dysentery), urological problems. However, it must be remembered that even if the child has confirmed the presence of any of the other diseases with similar symptoms, this does not mean the absence of appendicitis, since sometimes the baby may have several diseases at the same time. Therefore, even if you know how to check for appendicitis in a child, the final conclusion must be made by a specialist.

If inflammation of the appendix is ​​suspected:

• Monitor the baby.
• If abdominal pain persists for 2-3 hours, call an ambulance or take the child to the hospital. It is especially necessary to act quickly if, in addition, nausea, vomiting, and body temperature rise.
• Put the patient to bed.
• If vomiting or nausea occurs, small amounts of water may be given to relieve the condition and avoid dehydration.
• Putting a cold towel on the stomach ¾ will relieve the pain a little.

If a child is suspected of having appendicitis, do not:

• Heating the abdomen ¾ with heat will only accelerate inflammation, which threatens the development of peritonitis.
• Give pain relievers. In this case, the symptoms will “smear” and it will be difficult to establish a diagnosis.
• If you are constipated, do not give an enema (pressure will increase on the area of ​​inflammation) and do not give laxatives.
• Do not force feed, only a little water can be given.

Diagnosis of appendicitis

If symptoms are present, appendicitis in children is diagnosed on the basis of history, examination of the child and a number of laboratory tests. Although in most cases an experienced specialist can diagnose inflammation of the appendix with a visual examination, some tests are mandatory, in particular:

• Ultrasound is indicated in the presence of acute pain in the abdomen ¾ allows you to identify changes characteristic of acute appendicitis, the presence of possible complications, as well as changes in the abdominal cavity and pelvis, which may have symptoms similar to appendicitis in children.
• Diagnostic laparoscopy ¾ can be performed in some doubtful cases under general anesthesia, as the only method of visual assessment of the condition of the appendix before surgery.

If there is serious doubt about the diagnosis, the child is hospitalized and observed in a hospital. Observation should not exceed 2-6 hours. If necessary, the attending physician may involve specialists in other areas for consultation.

Treatment of appendicitis: surgical and postoperative periods

Appendicitis in children ¾ is a pathology, the mandatory treatment of which is surgery. Unfortunately, to date, there are no other ways to treat this disease. During the operation, the inflamed appendix is ​​removed, that is, an appendectomy is performed.

If we talk about appendicitis in children, then its peculiarity is its rapid development, therefore, in order to avoid possible complications, it is recommended to perform the operation as soon as possible.

Nowadays, this procedure is more often performed by laparoscopy ¾ through small incisions on the anterior abdominal wall, special equipment is inserted, with which the appendix is ​​removed. In some situations, an incision in the abdomen may still be required.

Children with uncomplicated forms of appendicitis are operated on immediately. In case of more severe symptoms (vomiting, high fever), preoperative preparation is carried out, which lasts no more than 2 hours.

After the operation, the child’s body is still weak, so he must stay in the hospital for several days. During this period, antibacterial drugs are administered (within 4-5 days after the operation) and painkillers (during the first day after laparoscopic appendectomy or 2-3 days after the traditional one). As a rule, on the 4-5th day after the operation, a control ultrasound, a clinical analysis of blood and urine is performed.

A few hours after surgery, the patient can be given some water. Kissels, compote, broth are allowed only after a day. On the second day after the operation, you can already give some food in small portions: low-fat sour-milk products, liquid cereals. After another day, it is allowed to add a little boiled fish or meat, dried bread, light soups, baked apples, weak tea. This diet should last 3 weeks after surgery. During this period, products that cause increased gas formation in the intestines (cabbage, beans, legumes, grapes) that cause fermentation and irritation of the mucous membrane are categorically contraindicated.

Physical activity is contraindicated after discharge from the hospital. With sudden movements, pain in the suture area may occur.

Prevention of appendicitis in children

Appendicitis in a child ¾ is a disease for which there is no prevention. However, to a certain extent, the incidence of appendicitis in children of different age groups, including young children, is affected by the structural features of the appendix (for example, the presence of bends), as well as the nature of the child’s diet.

For example, the fact that appendicitis is relatively rare in children under one year of age is associated with the fact that at this age the child eats mostly liquid and soft foods. Later, when the child switches to solid food, foreign objects, such as berry seeds, unpeeled seeds, etc., should not be allowed to enter the child’s gastrointestinal tract, which can clog the lumen of the appendix.

Among the causes of appendicitis in children, the leading role is often given to the baby’s own intestinal microflora, so the development of normal microflora from childhood may play a role in preventing the onset of inflammation of the appendix, although a direct link has not yet been established.

In any case, appendicitis ¾ is a disease that can occur in a child of any age, even in infants, and requires immediate treatment.