Patient education: Appendicitis in children (The Basics)

What is the appendix? — 

This is a long, thin pouch shaped like a finger. It hangs down from the large intestine, which is also called the colon (figure 1).

What is appendicitis? — 

This is when the appendix gets infected and swells. When this 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.

●Loss of appetite

●Nausea and vomiting

●Fever, which often starts after 1 to 2 days

Should my child see a doctor? — 

Yes. Call your child's doctor or nurse if your child has the symptoms listed above.

If they do have appendicitis, get treatment as soon as possible. The risk of the appendix bursting is much higher after the first 24 hours of symptoms.

Will my child need tests? — 

Maybe. Your child's doctor or nurse will first ask about their symptoms and do an exam. They 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, they might do 1 or more of the following tests:

●Blood tests

●Urine tests

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

No test can show 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 your child has appendicitis.

How is appendicitis treated? — 

The main treatment is surgery to remove the appendix, called an "appendectomy." This can be done in 2 ways:

●Open surgery – The doctor makes a cut ("incision") in the belly near the appendix. Then, they remove the appendix through the incision.

●Laparoscopic surgery – The doctor makes a few smaller incisions in the belly. They put long, thin tools through the incisions and into the belly. 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 screen to know where to cut and what to remove. Then, they use the tools to remove the appendix.

If your child's appendix burst, the doctor will also clean out the area around their appendix to wash away the material that spilled out. This makes the surgery more complicated than if their appendix had not burst.

A few days after an appendix bursts, if it is not treated, the body sometimes forms a wall around the appendix to block off the infection. When this happens, the treatment plan depends on the situation and how sick the child is. Your child's doctor will talk to you about the best approach. After they treat the infection, they will schedule surgery to take out the appendix. Without surgery, there is a higher risk of problems.

Can appendicitis be treated without surgery? — 

Sometimes. Appendicitis is usually treated with surgery. But in certain cases, if appendicitis is found very early and the appendix has not burst, the doctor might try treating it with antibiotics in the hospital. This is not an option for all children.

More on this topic

Patient education: Appendectomy (The Basics)
Patient education: Appendicitis in adults (The Basics)
Patient education: Nausea and vomiting in babies and children (The Basics)

Patient education: Nausea and vomiting in infants and children (Beyond the Basics)