Appendicitis in children. Appendicitis is an inflammation of the appendix. This is an appendix of the small intestine, located at the transition from the small intestine to the large intestine. It is also called the appendix and is located in the lower right corner of the abdomen. Appendicitis is also called appendicitis. It’s like a abdominal pain. Appendicitis can occur at all ages but is usually seen between the ages of fifteen and thirty. This condition occurs just as much in boys as in girls. Appendicitis is rare under the age of three. One in sixteen Dutch people will ever have to deal with appendicitis.
The symptoms of appendicitis occur fairly suddenly and develop rapidly. Usually, the following symptoms are present:
- severe abdominal pain around the navel, which later moves to the lower right of the abdomen
- fever (37.5 to 38.5 degrees)
- feeling sick
- severe pain when moving, jumping or riding over a bump
In addition, your child may suffer from:
- less fancy eating
- constipation or diarrhea
- a belly that feels hard
How does appendicitis develop?
Appendicitis in children is probably caused by the connection between the appendix and the colon. This would often involve a hard lump of stool. Children who eat little fiber can easily develop feces. Because of the occlusion of the appendix, it cannot empty itself. This allows bacteria to multiply there and lead to an inflammation of the appendix. If the exit of the appendix is narrowed, appendicitis becomes easier.
Is it serious and what can you expect?
An appendicitis is painful and can go seriously without treatment. An inflamed appendix can lead to inflammation of tissues near the appendix or burst open. This way a peritoneal infection can occur. Peritonitis occurs in one in five children with appendicitis. Peritoneal inflammation is a serious condition. In addition, your child becomes even iller. It can get a fast heartbeat and a high fever (above 38.5 degrees). To prevent this, appendicitis should always be treated.
Investigation If the doctor suspects that your child has appendicitis, he will send your child to the (pediatric) surgeon in the hospital. This examines your child further to see if there is indeed appendicitis or if there is another cause of the symptoms. During the examination, the (pediatric) surgeon listens and feels the abdomen. He also tries to feel the appendix with his finger through the anus (the poop hole). This can be annoying and painful for your child, but it is necessary to make the correct diagnosis. Blood is often taken to see if there are indications of inflammation in the blood.
The urine is also examined to see if there is no bladder infection. Sometimes it is necessary to have an ultrasound, photo or scan of the abdomen made. It is not always clear what the cause of the abdominal pain complaints is. In that case, it can be decided to wait a few hours at home or in the hospital to see how it goes with the abdominal pain complaints. If it is still not clear what is going on, a viewing operation can be performed. During the viewing operation, it is assessed whether the appendix is inflamed and can be removed immediately. Sometimes not only the appendix is inflamed, but also the tissues near the appendix. We call this an infiltrate and require treatment other than appendicitis alone. a viewing operation can be performed.
During the viewing operation, it is assessed whether the Appendicitis in children/appendix is inflamed and can be removed immediately. Sometimes not only the appendix is inflamed, but also the tissues near the appendix. We call this an infiltrate and require treatment other than appendicitis alone. a viewing operation can be performed. During the viewing operation, it is assessed whether the appendix is inflamed and can be removed immediately. Sometimes not only the appendix is inflamed, but also the tissues near the appendix. We call this an infiltrate and require treatment other than appendicitis alone.
Treatment If the appendix is diagnosed with appendicitis, your child will undergo surgery. Your child must be sober before the operation. This means that your child is not allowed to eat or drink twelve hours before the operation. Your child may have to wait a few hours for operation.
Anesthesia Before the operation, your child will be put to sleep with medication or via a drip or cap on the mouth. It is often possible to stay with your child until he/she sleeps. Operation The surgeon removes the inflamed appendix through a small incision in the abdomen. Sometimes this is done through a viewing tube and a video camera. During the operation, the surgeon checks to see if there is anything more inflamed than the appendix. If this is the case, the operation sometimes has to be extended and often leaves a somewhat larger scar.
After the operation After the operation, your child will go to the recovery room. It is often possible to be with your child when it wakes up again. If your child is well awake, it will go to the childcare department. Your child still has an IV drip in the arm, so that it receives fluid. For pain after surgery, your child will receive analgesic medication. The surgeon and the pediatrician examine the belly of your child. Due to the operation, the intestines do not move well during the first few days. If the intestines move well again, your child may carefully start eating and drinking. If this goes back to normal and there is little or no pain, it can go home after a few days. In most hospitals it is possible to be with your child, stay the night and take care of your child. Wound care is usually done by the nurse.
At home, The stitches can usually be removed after seven days. Sometimes the doctor does this and your child does not have to go to the hospital for this. Your child can do everything he wants to do at home. Often there is a follow-up check at the (pediatric) surgeon in the hospital a few weeks after the discharge. If your child feels good, it can also go back to school. Your child may still have slight abdominal pain after the operation. If the abdominal pain nevertheless becomes severe again or if your child develops a fever, it is advisable to contact your doctor.
Complications With every operation there is a chance of a complication. This chance is small with appendicitis. Due to a complication, recovery often takes longer and your child has to stay longer in the hospital. Complications can be:
- bleeding during or after surgery. Sometimes a new operation is needed to stop the bleeding
- the wound can become inflamed. With severe inflammation, it is often necessary to give antibiotics. If inflammation develops where the colon has been, the wound sometimes has to be opened again to allow the pus to come out
- adhesions of the intestines that may occur after surgery in the abdomen. Fortunately, this is not common. Behind such an adhesion, an intestinal loop can get caught and squeezed shut. Then severe abdominal pain occurs. In the event of severe abdominal pain after surgery, it is advisable to contact the doctor
Infiltrate Sometimes not only the appendix is inflamed, but also the tissue and the intestines in the area of the appendix. We then speak of an infiltrate or appendicular infiltrate. In that case, acute surgery is not useful, because it is not possible to remove all the inflamed tissue. We then wait for the inflammation of the intestines to disappear spontaneously. This can take a few weeks. Your child must rest at that time.
Sometimes your child is admitted to hospital for this, often it can also rest at home. If your child is very ill and has a high fever, medication (antibiotics) is often needed to help calm the inflammation. Your child is examined regularly and the blood is checked for inflammation. When the inflammation has settled, surgery is performed to remove the appendix.
When to the doctor?
Appendicitis in children/Abdominal pain in children can have many causes. You can find more about this in the information brochure ‘Abdominal pain in children‘. It is best to let your child identify the location of the abdominal pain. There may be appendicitis if your child:
- has abdominal pain, first in the entire abdomen and later in the lower right in the abdomen
- has a fever
- ill is
It is certainly advisable to contact your doctor. After examination, he/she will refer you, if necessary, to the (pediatric) surgeon in the hospital.
What can you do about appendicitis?
You cannot do anything about appendicitis. This must be treated in the hospital. For a sick child, examinations and treatments in the hospital can be annoying. It is therefore important to stay with your child and to see what you like in this situation. It is best to explain what is going to happen or have this explained clearly by the practitioner. Many hospitals also have picture books of examinations and treatments, so that your child knows what to expect. Take a familiar hug from home. Often it is also possible to go to the operating room until your child is asleep and be with your child again when it wakes up.
General advice and precautions for appendicitis
Appendicitis in children is often caused by hard lump stools. These occur when the stools pass slowly through the intestines. By ensuring good drainage through the intestines, the chance of appendicitis is reduced. Blockage or constipation must, therefore, be prevented as much as possible. The following measures help with this:
- let your child drink enough (at least 1 to 1.5 liters per day, depending on your child’s age)
- let your child eat enough fiber-rich products (wholemeal bread and wholemeal pasta)
- let your child exercise enough (walking, running or cycling for an hour every day)
Despite these measures, there is still a chance that your child will have appendicitis.