Childhood Appendicitis: Diagnosis and Treatment

The appendix is an extension of the colon, or large intestine.  This appendage has served to mystify physicians and researchers regarding its purpose in the human body.  According toLoren G. Martin, professor of physiology at Oklahoma State University, the appendix appears to perform functions related to the immune system.  Research indicate involvement of the appendix in the maturation of B lymphocytes, an important type of white blood cell, and the production of immunoglobulin A (IgA) antibodies, which help the body fight off infectious pathogens.

What Is Appendicitis?

The appendix occasionally becomes infected, allowing the associated bacteria to proliferate.  This results in the appendix becoming inflamed and possibly obstructed, causing acute abdominal pain and other symptoms.  Occasionally, the infection causes the appendix to rupture, spilling harmful bacteria and toxins into the abdominal cavity. A ruptured appendix is a serious, and possibly fatal, development of appendicitis.

How Common Is Childhood Appendicitis?

Doctors diagnose approximately 80,000 children per year with appendicitis and commonly strikes between the ages of 10 and 20 years.  It is the most common reason children undergo emergent surgery of the abdomen.  Half of the minor patients who present with acute appendicitis have a family history of the condition.  Rupture of the appendix occurs in 30 percent of patients, but most commonly in those under the age of 5.

What Are the Symptoms in Children?

The common early signs of appendicitis, such as vomiting and nausea are often absent in children. Children with often complain of constipation or produce small amounts of stool containing mucus in the early stages of the disease.  They might have abdominal pain that may, or may not, be accompanied by a fever. Parents often think the symptoms appear like those of viral syndromes causing intestinal disturbances that their child has had and quickly overcome in the past.  If you feel the symptoms may indicate appendicitis, get to your local pediatric clinic immediately.  Since appendicitis symptoms in children are similar to those of other common childhood diseases, doctors often find it challenging to diagnose.

Are There Tests That Can Confirm Appendicitis?

If your child’s pediatrician suspects appendicitis, he will perform a manual examination of the abdominal area to check for focal pain and tender spots.  He will also order blood and urine tests, chest and abdominal X-rays, and a CAT scan to aid in confirming or eliminating the condition.  If the tests indicate appendicitis, he may tell you not to give your child anything to eat or drink from that point forward in preparation for surgery.

How Is Appendicitis Treated?

Doctors treat appendicitis by removing the appendix through a surgical procedure called an appendectomy.  Prior to and after surgery, your child will receive intravenous (IV) fluids and antibiotics to prevent post-surgery infection and complication.  The procedure requires a two to three day hospital stay, during which medical staff will monitor your child’s vital signs, check the surgical wound, and administer pain medications as needed.

Ruptured appendix occurs when the signs of appendicitis have been misdiagnosed and remained unchecked.  If this happens, serious complications or death can occur.  A ruptured appendix can cause peritonitis or abscess, which can lead to organ failure or death.  Surgery is still required to remove the ruptured appendix and to wash out any bacteria and fluid contents that spilled into the abdominal cavity.  The attending physicians will require a longer hospital stay for the child so they can closely monitor his recovery and allow the IV antibiotics to eliminate any remaining infection.

Post Surgery

Remember to follow all the pediatrician’s orders regarding bed rest for your child, wound cleaning, wound dressing, and medication.  Your pediatrician will ask you to follow up with an office visit seven to 10 days after surgery.  Call your pediatrician or head to an emergency room if you see swelling, redness, or increased bleeding at and around the incision area.

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