What is appendicitis?
Appendicitis is a condition which involves the inflammation of the appendix. The appendix is a pouch, which comes out from the intestine, and it is located on the right lower side of the abdomen. The condition can cause pain in this area of the abdomen, but usually starts around the navel and moves toward the right lower part of the tummy. Pain from appendicitis usually becomes progressively worse as inflammation increases.
Anybody can have appendicitis, but research has shown that it is more likely to occur in people ages between ten and thirty years. Children younger than seven years old have appendicitis with specific signs and symptoms and an expert children’s surgeon should be involved from an early stage to avoid complications.
Written by: Stefano Giuliani
Written on: 10.07.18
Appendicitis in children: signs to watch out for
Appendicitis can be a serious problem at any age. With all the tummy aches that children may experience, it can be hard to spot. Mr Stefano Giuliani, leading London-based paediatric surgeon, gives us the low-down on how appendicitis in children is diagnosed and what can be done about it.
What causes appendicitis?
The most likely cause of appendicitis is the blockage in the lumen of the appendix. This results in bacterial overgrowth and a localised infection to start with. The appendix inflames more and more as the bacteria multiply until it becomes swollen and filled with pus. If not treated promptly at this stage, the inflammation can spread to the entire tummy (peritonitis) and to the rest of the body with very serious consequences.
Symptoms of appendicitis
The most common signs of appendicitis are: pain in the naval region that migrates to the lower right side of the abdomen; complete loss of appetite; nausea; pain which gets worse when your child is coughing or jumping; diarrhoea or bowels not open for a few days.
The site of pain can differ according to the severity of the appendicitis, the age of the child and the location of the appendix.
Treatment options for appendicitis
It is important that appendicitis is treated, as it has the potential to cause serious complications, including: a ruptured appendix, which causes peritonitis (when the infection spreads through the abdomen), a potentially life-threatening condition; or an abscess, should the appendix burst in a contained area and a pocket full of pus develops in the abdomen.
Appendicitis is usually diagnosed using a range of tests and investigations, including: a physical examination, which may involve the doctor gently applying pressure to the affected area, and assessing the response of your child's abdominal muscles; a blood test; an ultrasound scan; and rarely in children CT scan of the abdomen.
Treatment usually requires surgery to remove the appendix and eliminate the source of infection. This operation is called appendectomy. Your child will be given antibiotics before the procedure and for a few days after depending on the severity and spread of the infection. An appendectomy can either be performed as a laparoscopic procedure (key-hole surgery), involving a few small incisions, or as an open surgery, involving an incision of about five centimeters in the right lower part of the tummy. Laparoscopic surgery - which is favoured for being minimally invasive and requiring a shorter recovery time - involves the surgeon inserting a tiny camera through one of the incisions in order to guide the procedure, while small surgical tools are inserted via two more small incisions.
For cases in which your child's appendix has ruptured, and the infection has spread, an expert paediatric surgeon may decide to treat your child with antibiotics only (conservative management) for a few weeks and to delay the surgery for when the child has recovered from the acute phase of the disease.
During the recovery period following an appendectomy, your child will be given pain killers, and any strenuous exercise should be avoided for 2-3 weeks.
"Mr Giuliani treated our 15-year old daughter for a complicated appendicitis. From the first consultation onwards Mr Giuliani was professional, caring and reassuring. His secretary, Helen, has also been excellent from the start and so helpful. We would definitely recommend Mr Giuliani and his team at the Portland Hospital who provided such great care to our daughter. Thank you!"
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