KIDS MD All About Appendicitis

By Dr. Christopher Pennell

Stomach pain and fevers – a dreaded combination for many parents – are some of the most common symptoms children experience when they’re not feeling well. Although these symptoms can be caused by many things and typically resolve on their own, sometimes they indicate a more serious problem – appendicitis. As a parent, it’s good to know what to watch for, so you can contact your child’s doctor before the problem gets worse.

Appendicitis is an infection of the appendix, a small organ attached to the colon in the lower right side of the abdomen. About 7 percent of people in the U.S. develop appendicitis in their lifetime, with kids between the ages of 10 and 18 most affected. Although it’s less common in young children, about 10 percent of cases do happen in children under the age of 5.

So, what should you be on the lookout for?

Appendicitis usually starts as a vague pain around your child’s belly button that characteristically worsens and moves to the lower right abdomen over about 24 hours. This is typically associated with decreased appetite, vomiting and fever that follows the onset of pain.

Although this is typically how appendicitis presents, if your child’s symptoms aren’t exactly like this and you’re still concerned, don’t hesitate to call your pediatrician. You’re never wrong for asking a doctor to take a look.

Based on your child’s symptoms, your pediatrician will let you know if you should come to their office first or go straight to the ER for further evaluation. In most cases, blood tests and imaging will be recommended. Ultrasound is preferred in children because there’s no radiation; however, there are some cases where a CT scan might be helpful.

If the evaluation shows appendicitis, your child will likely need to have their appendix removed.

Surgery is most commonly done laparoscopically, which means doctors will use a video camera and instruments placed through small incisions in the abdomen.

Most children go home within 24 hours of surgery. In some cases, like when the appendix has ruptured and spreads infection through the abdomen, your child may be admitted to the hospital to receive IV antibiotics. Although a “ruptured appendix” sounds scary, it’s common and occurs in about one in three cases. No parent wants to see their child undergo surgery, but the good news is that nearly all children fully recover from the infection with no serious, long-term problems.