Appendicitis

What is the appendix? — The appendix is a long, thin pouch that is shaped like a finger. It hangs down from the large intestine, which is also called the colon (figure 1).

What is appendicitis? — Appendicitis is the term doctors use when the appendix gets infected and swells. When that happens, the appendix can sometimes burst. A burst appendix can be serious, because it can cause a bad infection.

Appendicitis can happen in children and adults. When it happens in children, it is more likely to affect older children and teens than babies or younger children.

What are the symptoms of appendicitis? — Symptoms can be different, depending on a child’s age. The most common symptoms are:

Belly pain – In older children and teens, belly pain is usually the first symptom. The pain might start around the belly button and then move to the right side of the lower belly. Children can also have belly pain that gets worse with coughing or hopping.

Vomiting

Fever – Fever often starts after 1 to 2 days.

Loss of appetite

Should my child see a doctor or nurse? — Yes. Call your child’s doctor or nurse if your child has the symptoms listed above. If your child does have appendicitis, it’s important to get treatment as soon as possible.

Will my child need tests? — Maybe. Your child’s doctor or nurse will first ask about the symptoms and do an exam. The doctor or nurse might be able to tell if your child has appendicitis without doing any tests.

If the doctor or nurse can’t tell for sure if your child has appendicitis, he or she might do one or more of the following tests:

Blood tests

Urine tests

An imaging test such as an ultrasound or CT scan – Imaging tests create pictures of the inside of the body.

No test can say for sure if a child has appendicitis. But the doctor or nurse can use the test results, symptoms, and exam to figure out how likely it is that your child has appendicitis.

How is appendicitis treated? — The main treatment for appendicitis is surgery to remove the appendix. This surgery can be done in 2 ways:

Open surgery – During open surgery, the doctor makes a cut in the belly near the appendix. Then he or she removes the appendix through that opening.

Laparoscopic surgery – During laparoscopic surgery, the doctor makes a few cuts in the belly that are much smaller than cuts for open surgery. He or she puts long, thin tools into the belly through these openings. One of the tools has a camera (called a “laparoscope”) on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to know where to cut and what to remove. Then he or she uses the tools to do the surgery.

If your child’s appendix has burst, the doctor will do surgery to remove the appendix. During the surgery, he or she will also clean out the area in the belly around the appendix to wash away the material that spilled out of the burst appendix. This surgery can be more complicated than the surgery that is done if the appendix has not burst. If it has been more than a few days since your child’s appendix burst, your child might not have surgery right away. That’s because the body sometimes forms a wall inside the belly, to block off the area that became infected when the appendix burst. In cases like these, the doctor will first treat your child with antibiotics and watch him or her. He or she might take the appendix out once the antibiotics have made your child feel better, or stick a needle in the walled-off area to drain the infected fluid. This treatment is usually done at the same time as an imaging test, so that the doctor can see where to put the needle. After the doctor treats the infection, he or she might recommend that your child have surgery later on.

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