When Your Child Has Appendicitis

Appendicitis is an infection of the appendix. The appendix is a small hollow structure that is attached to the colon (large intestine). The appendix does not have a clear function in the body. But it can sometimes become blocked and infected. If this happens, surgery is almost always required to remove it. Appendicitis is a very serious medical condition that needs immediate treatment.

The Appendix

When the appendix is healthy, liquid waste moving through the colon passes in and out of the appendix without problems. But the entrance to the appendix can sometimes become blocked. Inflammation (swelling) due to blockage can trap waste inside the appendix, causing an infection. An infected appendix is at risk of rupture (bursting). If your child’s appendix ruptures, infected fluid leaks into the abdomen (belly). This can be very dangerous.

What Are the Symptoms of Appendicitis?

Symptoms of appendicitis can appear very quickly (over a period of hours to a day or two). Common symptoms include:

• Pain starting in the center of your child’s belly that moves to the lower right side

• Increased pain and pressure when your child walks

• Vomiting, nausea, or decreased appetite

• Fever or fatigue (extreme tiredness)

• Diarrhea (loose, watery stool) or constipation (hard, dry stool)

Surgery is needed to remove an infected appendix before it ruptures.

How Is Appendicitis Diagnosed?

An examination will be performed so the doctor can locate your child’s pain. The doctor will ask questions about your child’s medical history, and may order some tests, such as:

• Blood or urine tests

• X-ray, ultrasound, or CT scan (tests that take pictures of your child’s appendix)

How Is Appendicitis Treated?

Surgery (appendectomy) is needed to remove the infected appendix. An appendectomy may be performed one of two ways:

• Open surgery: A single incision (about 2–3 inches long) is made in the lower right part of the abdomen. This lets the surgeon see the appendix clearly. The incision might need to be bigger if the appendix has ruptured.

• Laparoscopic surgery: Between 2–4 small incisions are made in your child’s abdomen. A laparoscope (a thin tube with a tiny camera and light attached) is inserted through one incision. It shows the surgeon the inside of your child’s abdomen on a screen. The surgeon inserts surgical tools into the other incisions, guided by pictures from the camera on the screen.

The incision(s) will be closed with sutures or staples. A tube may be inserted for a short time to drain any leftover fluid. If the appendix ruptured, the outer layers of the incision may be left open. This lets the incision drain more easily. It may heal on its own or be closed by the surgeon about 5 days later.

Your Child’s Recovery from Appendectomy

• After appendectomy, your child may be in the hospital for 1–2 days (7 days or longer if the appendix ruptured).

• Your child will be given medication to stay pain-free.

• Fluids may be given through an intravenous (IV) line.

• Your child may also be given antibiotics to prevent or fight infection.

• Your child will be given only liquids at first to let the intestine heal from the surgery. Later, your child can return to eating solid foods.

• Once at home, your child should avoid heavy lifting, contact sports, and rough play for a few weeks. Normal activity may be resumed once the incisions heal.