Appendicitis

The appendix is a small, worm-shaped off-shoot of the large intestine that has no known function. Appendicitis develops when the appendix—for reasons that are still unclear—becomes inflamed. The great danger of appendicitis is that the organ can fill with pus and eventually burst, spreading bacteria throughout the abdominal cavity and causing a dangerous condition called peritonitis. To prevent this complication, an infected appendix should be removed surgically.

Appendicitis affects approximately one in 500 children under the age of 14 each year in the United States. It is rare in children under two, but at that age the consequences can be more serious.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS APPENDICITIS?
Appendicitis in a child may be difficult to diagnose because there are so many reasons for abdominal pain, and young children often cannot communicate just how bad the pain is. Appendicitis should be suspected if the pain begins as a dull or vague discomfort near the navel and then sharpens and localizes as it moves toward the lower right section of the abdomen, the site of the inflamed appendix. Within a few hours, the intensifying pain becomes constant and the lower abdomen becomes extremely sensitive to the touch.

Symptoms of appendicitis do not follow any set pattern, however. The precise location of the appendix varies from person to person and so will the focus on the pain. Frequently, the pain will be felt in the side, back or anywhere in the lower abdomen.

IS MEDICAL ATTENTION NECESSARY?
Yes. Appendicitis is a medical emergency. Untreated appendicitis can lead to a perforated appendix, which is a serious, life-threatening condition. If your child has vomiting, abdominal pain and tenderness suggesting appendicitis, call your doctor immediately. If the pain is severe, go straight to the emergency room. Do not give your child anything to eat or drink or administer laxatives or pain killers.

WHAT TREATMENT IS AVAILABLE?
The only treatment is surgery to remove the appendix (an appendectomy). If there is time, your doctor will usually try to confirm the diagnosis first with a series of tests such as blood studies and abdominal ultrasound. On occasion, however, surgery must be performed immediately on the basis of symptoms alone.

An uncomplicated appendectomy is a simple, safe procedure requiring a hospital stay of no longer than three to five days. A course of antibiotics may be prescribed to eliminate any infection, and your child will be back to normal in two to three weeks. Surgeons are currently developing a method of performing appendectomies using a lighted magnifying instrument (a laparoscope) and surgical instruments inserted into the abdomen through a small incision.

GETTING HELP
Call your doctor if your child:

• Has abdominal pain that begins intermittently, then intensifies and becomes constant

• Cannot move without pain

• Cries out in pain when the tender area is touched

• Feels sharp pain when coughing or sneezing

• Has a fever, but no throat or ear pain

• Lies with the right leg bent in or will not put any weight on the right

• Has some of the above symptoms along with nausea, diarrhea or constipation

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.