What is appendicitis?
Appendicitis is a painful swelling and infection of the appendix (a narrow, finger-like pouch that branches off the large intestine). Doctors are not really sure what the appendix does, but removing it is not harmful. Appendicitis is the most common cause of emergency surgery in childhood.
Since an infected appendix can rupture and be a life-threatening problem, call your health care provider or go to the emergency room immediately if your child has these symptoms:
- sudden, pronounced pain around the belly button area
- in a short period of time, the pain moves to the lower right-hand part of the abdomen and your child may have a difficult time breathing
What are the symptoms of appendicitis in children?
The following are the most common symptoms of appendicitis in kids. However, each child may experience symptoms differently. Symptoms may include:
- pain in the abdomen, which may start in the area around the belly button, and move over to the lower right-hand side of the abdomen, but may also start in the lower right-hand side of the abdomen
- usually increases in severity as time passes
- may be worse with moving, taking deep breaths, being touched, coughing or sneezing
- may spread throughout the abdomen if the appendix ruptures
- nausea and vomiting
- loss of appetite
- fever and chills
- changes in behavior
- diarrhea or constipation
What causes appendicitis in children?
Appendicitis occurs when the interior of the appendix becomes filled with something that causes it to swell, such as mucus, stool, or parasites. The appendix then becomes irritated and inflamed. The blood supply to the appendix is cut off as the swelling and irritation increase. Adequate blood flow is necessary for a body part to remain healthy. When the blood flow is reduced, the appendix starts to die. Rupture (or perforation) occurs as holes develop in the walls of the appendix, allowing stool, mucus, and other substances to leak through and get inside the abdomen. An infection inside the abdomen known as peritonitis occurs when the appendix perforates.
What happens during appendix surgery for children?
The appendix may be removed in two ways:
- Open method. Under anesthesia, an incision is made in the lower right-hand side of the abdomen. The surgeon finds the appendix and removes it. If the appendix has ruptured, a small drainage tube may be placed to allow pus and other fluids that are in the abdomen to drain out. The tube will be removed in a few days, when the surgeon feels the abdominal infection has subsided.
- Laparoscopic method. This procedure uses several small incisions and a camera called a laparoscope to look inside the abdomen during the operation. Under anesthesia, the instruments the surgeon uses to remove the appendix are placed through the small incisions, and the laparoscope is placed through another incision. This method is not usually performed if the appendix has ruptured.
After surgery, children are not allowed to eat or drink anything for a specified period of time so the intestine can heal. Fluids are given into the bloodstream through small plastic tubes called IVs until your child is allowed to begin drinking liquids. Your child will also receive antibiotics and medications through the IV to help her feel comfortable. Eventually, children will be allowed to drink clear liquids (such as water, sports drinks like Energade or PowerAde, or apple juice), and then gradually advance to solid foods.