Appendicitis is an inflammation of a part of the intestine called the appendix, a narrow, finger-shaped sac near where the small and large intestines come together. If the opening of this sac becomes blocked, the appendix can become red, swollen, irritated, and painful. Bacteria get trapped in the appendix and can infect the tissue in that area. If untreated, an inflamed appendix can rupture, spreading the infection into the abdominal cavity and bloodstream. Appendicitis affects about 5 percent of the population (one in 20 people). Although it may occur at any age, appendicitis is most common in teenagers and young adults. It is the main reason for abdominal surgery in children.
The symptoms of appendicitis in children can be similar to those of other common conditions, such as acute gastroenteritis (an infection of the intestines caused by bacteria or viruses), constipation, or trapped gas. Appendicitis usually starts with slight fever (100.4 - 101.3°F), loss of appetite, and pain near the belly button. The pain may come and go, but it will gradually increase and eventually become constant. After the onset of abdominal pain, nausea and sometimes vomiting may follow. Children may have mild diarrhea; others may experience the need to urinate more often. After a few hours, the pain usually moves to the right side of the lower abdomen; this shift signals that the inflammation may be spreading from the appendix to the abdominal cavity.
Unfortunately, it is impossible to prevent appendicitis.
The majority of children with abdominal pain do not have appendicitis, so do not give pain medications to a child with abdominal pain before a doctor's examination. Pain medication can disguise the child's symptoms and may allow the illness to develop further before being diagnosed. Alert a doctor if your child has symptoms that are suggestive of appendicitis. The doctor may order blood tests and X-rays, although no test can diagnose appendicitis with complete accuracy. Sometimes, the diagnosis will remain uncertain and the doctor will admit the child to a hospital for observation.
If the condition is not quickly diagnosed and treated, the inflamed and blocked appendix may burst open, causing pus (infected fluid) to enter the abdominal cavity. This causes peritonitis, an inflammation of the lining of the abdominal cavity, or peritoneum. When the infection spreads to the peritoneum, the child will seem much more ill, with worse pain and higher fever. The child's stomach will be tense and painful even to touch. This can be a life-threatening situation, and the child must need an appendicitis surgery, called an appendectomy, to remove the infected appendix.
The appendix can be removed through traditional surgery, which involves a long incision into the abdomen, or using laparoscopic surgery, a less invasive technique that uses small instruments and a video camera that's inserted through several very tiny incisions. In addition to surgery, the child will often need intravenous fluids, pain relief medication, and antibiotics. A child with uncomplicated appendicitis will usually go home from the hospital within two to three days but if the appendix has burst a longer stay may be necessary.
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