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: Appendicitis in children: often difficult to diagnose

DEAR DR.PAUL: I was wondering, do children get appendicitis, and if so, what are the signs of appendicitis in children?

PEDIATRICIAN DR.PAUL ANSWERS: The answer to your first question is easy. Yes, children can suffer from appendicitis. Your second question is a bit more complicated. First, let me explain what appendicitis is. It is the inflammation (usually infection) of the appendix, which is a small extension or pouch of the large intestine. What is the role of the appendix? It is believed, just like the tonsils, that the appendix may be involved in the development of the immune system as a baby develops in the uterus.

Now to your next question: The classic symptoms of appendicitis in adults as acute (sudden onset) abdominal pain, typically, starting around the belly button area and then moving down to the right lower side of the abdomen. There can be nausea with or without vomiting, and there may be a low-grade fever. There are also some very specific findings that a doctor looks for when examining a person with suspected appendicitis, including very tender right lower abdomen, and pain in the same area with movement of the body (jumping up and down or even walking). There are really no specific tests to confirm the diagnosis. A blood test and regular X -Ray of the abdomen may or met not be helpful. More recently ultrasounds have been found helpful in confirming appendicitis.

The diagnosis is made based on an evaluation by a surgeon. If the surgeon strongly suspects appendicitis, then the treatment is to operate and remove the inflamed appendix. This is the only treatment of appendicitis, because if left untreated, the appendix will become so inflamed and swollen, that it will rupture. A ruptured appendix is quite serious and potentially life threatening; the material normally in the appendix, full of bacteria, spreads within the abdomen and can get into the blood. If this happens, aside from surgery, antibiotics are needed after the operation for a prolonged period to prevent spread of infection. Fortunately, in most cases, the appendix is removed before it ruptures, usually with a quick recovery and without the need for other treatments.

Before talking about the symptoms in kids, it is important to understand that abdominal pain in childhood is quite common, accounting for tens of thousands of doctor visits annually: But only a very small percentage of children with abdominal pain actually have appendicitis. However, when appendicitis occurs in children, it can present as I have described above, but can also reveal itself with very non-specific or non-typical symptoms. Every one training in Pediatrics or Pediatric Surgery can attest to the fact that at one time or another they have been fooled; diagnosing something else, and indeed it ending up being appendicitis. If the doctor or surgeon is not fully convinced that this is appendicitis, there are several options, depending on the individual situation: A physician may send the child home advising the parents to bring the child right back if the pain worsens or persists. Still in other cases, the child might be admitted to hospital for observation.



The information provided in this site is designed to be an educational aid only. It is not intended to replace the advice and care of your child's physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition, always consult a physician.

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