Appendicitis is a well-known condition that many people are familiar with, but did you know it can also occur in children? And it’s even more concerning when it happens to young children who can’t clearly communicate their abdominal pain to their parents, which can delay medical attention. A delayed diagnosis can lead to the condition worsening, possibly resulting in a ruptured appendix.

Parents should be attentive if they notice their child experiencing stomach pain and should not hesitate to take them to the doctor for diagnosis and treatment as soon as possible, to ensure prompt care.

What causes appendicitis in children?
Appendicitis in children occurs when there is a blockage in the appendix. This blockage can be caused by enlarged lymphoid tissue (lymphoid hyperplasia), fecalith (stool stone), or foreign bodies. While the appendix normally produces mucus in its lumen, the blockage prevents the pus from draining out, leading to accumulation. This increases the intraluminal pressure and reduces blood flow to the appendix, causing oxygen deprivation and the formation of ulcers in the mucosal layer. As a result, bacteria may spread.

The combination of bacterial invasion and vascular impairment can lead to appendicitis, which may cause the appendix to rupture. Pus may spread throughout the abdominal cavity, leading to infection in the bloodstream, which can become life-threatening.

Symptoms of appendicitis in children that parents should watch for
The symptoms typically begin with nausea and abdominal pain. Initially, the pain is around the belly button and may not be clearly localized (visceral pain). It then shifts to the lower right side of the abdomen (parietal pain), where the pain becomes more localized and can be pointed out. In some cases, the pain may be present from the start in the lower right side, which is where the appendix is located.

Afterward, the child may experience nausea, vomiting, diarrhea, or a mild fever. If the abdominal pain persists for more than 48 hours, there is a higher chance of a more severe appendicitis. For younger children who cannot communicate their symptoms, they may show signs of abdominal pain, reluctance to eat, possible vomiting, and a mild fever in the early stages.

Diagnosis of appendicitis
When a patient visits the doctor, the following steps are typically taken to diagnose appendicitis:

1. Measure blood pressure and check vital signs.
2. Take a medical history, focusing on abdominal pain and other associated symptoms.
3. Physical examination to assess the patient’s condition.
4. Laboratory tests, such as blood tests, to check for signs of infection or inflammation.
5. Imaging tests, such as X-rays, ultrasound, or a CT scan, to visualize the appendix and confirm the diagnosis.
 

Treatment of appendicitis in children
The treatment for appendicitis typically requires surgery. Appendectomy (removal of the appendix) can be performed through either open surgery or laparoscopic surgery. The doctor will provide details about the surgery and recommend the most suitable approach for each patient. Before the surgery, the patient will be instructed to refrain from eating and drinking (NPO), receive intravenous fluids (fluid resuscitation), and be given antibiotics to cover gram-negative bacteria and anaerobes.

When appendicitis is diagnosed, preparation for surgery includes assessing dehydration, which is crucial, as dehydration can develop quickly in children due to infection, vomiting, or fever. Proper hydration before surgery can help reduce the risk of complications during the procedure.

Whenever parents suspect their child may have appendicitis, they should not delay and should seek medical attention immediately. Appendicitis in children can progress to rupture more quickly than in adults. While surgery may seem frightening, early intervention allows for timely diagnosis and treatment by a skilled medical team, ensuring safety and a positive outcome.