What is Appendicitis?
Appendicitis is a condition where the appendix, a small tube located in the lower right side of the abdomen, becomes inflamed. While the appendix is part of the bowel, it doesn’t play an important role in the body, and you can live without it. Appendicitis can affect anyone, but it’s more common in older children and teenagers. It rarely occurs in children under the age of five.
The appendix sits at the start of the large intestine. It looks like a little worm, and may help with bacteria in the gut.
In most cases, appendicitis occurs when the appendix becomes inflamed – most commonly when something, often a small piece of hard stool (poo), gets stuck in the appendix. This blockage causes swelling and infection, which requires urgent medical treatment. The standard treatment for appendicitis is the surgical removal of the appendix, known as an appendicectomy. This is mostly performed laparoscopically (keyhole surgery).
Signs and Symptoms of Appendicitis in Children
Appendicitis symptoms can vary between children, but some common signs to watch for include: –
Pain starting near the belly button that then moves to the lower right side of the abdomen. This can occur after 12-24 hours.
Loss of appetite: They may not feel like eating or drinking.
Nausea and vomiting: Your child may feel sick or vomit.
Fever: A mild to moderate fever may be present after 12-24 hours.
If your child experiences any combination of these symptoms, especially abdominal pain that worsens with movement or touching, it’s important to seek medical attention immediately.
When Should You See a Doctor?
If you suspect your child has appendicitis, or if they have the symptoms listed above, take them to a GP or the nearest emergency department as soon as possible. Appendicitis can worsen quickly if left untreated. If the appendix bursts, it can leak its contents into the abdomen, leading to a more serious infection called peritonitis, which can make your child very sick.
If your child is in significant pain that worsens with movement, or if pressing on their stomach makes the pain worse, go straight to the emergency department.
How is Appendicitis Diagnosed?
To diagnose appendicitis, the doctor will ask about your child’s symptoms and medical history. They will also perform a physical examination by pressing on the abdomen to check for tenderness. They will also need to examine the groin for hernias, and in boys, the scrotum as testicular problems can also lead to abdominal pain.
In some cases, diagnosing appendicitis can be challenging because stomach pain can be caused by various conditions. If the team is unsure, they may perform blood tests or scans to help, as well as keep your child in the hospital for observation, as the diagnosis can become more clear as time passes.
Diagnostic Tests for Appendicitis
Ultrasound scan: This tests may be done to look at the appendix and check for signs of inflammation in the region. Please note, there are a number of secondary signs of appendicitis. The measurement of appendix diameter is not the main indicator of appendicitis.
Blood tests: Blood tests can be used to check for signs of infection or inflammation in the body.
Surgical Diagnosis: About half the children who present to the emergency department do not have a specific diagnosis. The main issue is to make sure it is not something that requires urgent treatment such as surgery. In some cases, if the cause of the tummy pain is unclear, your doctor may recommend surgery to check the appendix, even if they are not certain it is inflamed. This is called diagnostic laparoscopy.
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