An Illness Even M.D.s Can Miss: Appendicitis in Children

Tricky Complications

Surgeons have two methods for removing an appendix, both of which are performed under general anesthesia and take from 30 to 60 minutes. The technique used depends on the doctor, the hospital, and the child. In a traditional open surgery, the doctor makes an incision between a half inch and 2 inches on the right side of the abdomen. Josie had a laparoscopy, a newer procedure where the surgeon makes tiny incisions on the abdomen and uses a telescope and a camera to locate the appendix.

Unfortunately, complications after surgery are common, says Dr. Lally. About 5 percent of children develop a bowel obstruction. The treatment can consist of inserting a tube to drain what's causing the obstruction, or it may require further surgery. And 15 to 20 percent of children with a rupture will develop an abscess, an infection caused when pus collects in the abdomen. It's usually drained and treated with IV antibiotics for up to two weeks.

Like many patients recovering from a ruptured appendix, Josie wasn't allowed to eat anything other than ice pops and ice chips until her bowel began working again. After that, she was given solid food. She spent another two days in the hospital while doctors made sure her digestive system was functioning properly. She was on IV antibiotics during her entire hospital stay.

The appendectomy took a lot out of Josie -- and her family. "She wasn't eating and wasn't getting out of her hospital bed," Catherine recalls. "It became harder for me to imagine her feeling better. I thought, 'How can she bounce back from the state she's in?'" Before the doctors released Josie, they warned her parents that she could develop a fever or more pain.

Back home in Neenah three days later, that's exactly what happened, and she had to be admitted to the Children's Hospital of Wisconsin in Milwaukee. Hooked up again to IV antibiotics, Josie underwent several CT scans that eventually showed she had developed an abscess.

Josie needed to be sedated with a general anesthetic so that the surgeon could insert a plastic tube into her lower abdomen to drain the infected pus. The tube remained in place for three days. If the drain didn't work, or if she had had multiple abscesses, she probably would have required further surgery.

A Full Recovery

Happy child with fixed health problem

Jenny Risher

For all the trauma surrounding her experience, Josie doesn't seem to have bad memories of it. When passing the hospital a few months after being discharged, she announced what she would do if her friends wound up there: "I'll visit them and bring cards to help them feel better."

Catherine has a different take on the situation. "The whole incident really shook my faith in my children's robust good health as well as my own ability to recognize a serious problem when I'm faced with it," she says. "Thank goodness this one had a happy ending."

Dr. Lally's advice is simple: Use common sense. If your child is acting unusual or has severe pain, go to your doctor or to the emergency room. Try to write down the symptoms and share that information with the doctor. "You are partners," Dr. Singhal says. "Everyone wants the best outcome: a healthy, happy, pain-free child."

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