Appendicitis in Child

Appendicitis is an acute inflammation of the appendix, which is a small piece of bowel that lies in the right side of the lower abdomen. It has no useful or functional benefits in humans but occasionally it can get blocked or inflamed and cause appendicitis.

Symptoms

Appendicitis usually presents with pain, sometimes starting around the belly button and then moves to the right hand side. The pain tends to be constant and made worse by movement. There may be a raised temperature and there is often loss of appetite and nausea. Vomiting is a common feature. Typically children with appendicitis feel quite unwell in themselves

Causes

In most cases, appendicitis occurs due to a blockage of the lumen of the appendix, leading to overgrowth of bacteria and subsequent infection and inflammation.

Treatment

Once the diagnosis of appendicitis is made it may mean that your child will require an operation – an appendectomy. Although this is an urgent operation, it does not need to happen immediately. It is much more important that your child is treated with antibiotics and given fluids though a drip which will enable them to feel a lot better. The antibiotics and the fluids are actually very successful treatments for appendicitis and this way they have the best possible chance of recovering faster and being discharged quickly following surgery. Sometimes there can be a perceived delay from the time of diagnosis to the time of surgery, but as long as your child has been treated with antibiotics and the fluids, this is all part of the normal treatment plan.

Post-Op

Afterwards your child will require pain relief, fluids through a drip, and will need more antibiotics. Depending on how inflamed or complicated the appendicitis is will impact upon the child’s length of stay. Children with mild appendicitis will only be in hospital for a few days. Children with more severe appendicitis can be in the hospital, on IV antibiotics for at least five days. Over the next number of days the child will be encouraged to get out of bed and return to a normal diet as quickly as possible. As soon as they are well they will be discharged home, however in those children with more complicated or inflamed appendix they will stay for a minimum of five days and recovery can take longer than that. Surgeons and nurses will be assessing your child on a regular basis. If you have any questions or concerns please feel free to ask any member of staff.

FAQ’s

When your child attends the casualty department they will be evaluated by a number of doctors to see whether or not a diagnosis of possible appendicitis can be made. This can be quite challenging as it is one of the most difficult diagnoses to make in children and in adults. The vast majority of children who present with abdominal pain do not have appendicitis and unfortunately there are no quick and easy tests that can distinguish appendicitis from other causes of your child’s pain and discomfort. Your child will be evaluated by a surgeon and regular blood and urine tests will be performed to try to determine the diagnosis. Parents frequently ask and wonder whether a scan will be beneficial and the majority of times ultrasounds, scans or x-rays of tummy are of very limited benefit in diagnosing appendicitis. In reality the most useful thing is repeated assessments by the surgeon. Your child will be admitted and then reviewed on a number of occasions, and will be given IV fluids through a drip and pain relief. All the appropriate care will be provided until we can clearly diagnose what is going on.
Your child will go to theatre and have an operation. This is always a time of stress and anxiety for parents but the operation is being performed by skilled surgeons, anaesthetists and a surgical team who are experts in this procedure. We are children surgeons, and our nursing staff are dedicated to looking after children. The majority of children who do have an appendectomy now have it through a key hole technique which involves using a laparoscope or small camera which is inserted into the abdomen. With some children it is better that it is done in an open procedure.

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Mr. Feilim Murphy

MB, BCH, BAO, FRCSI (Paeds)
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MBBS, FRCS (Paed), MD
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