Wellness & Fitness

How to manage appendicitis in children

kid

A ‘stomach ache’ is one of the common reasons a parent may bring their child for evaluation by a doctor. It may be due to constipation or bloating, but sometimes it may be associated with more serious conditions. If a child’s pain begins in the belly-button area and spreads to the lower right abdominal area, it may be the result of appendicitis. Appendicitis is an inflammation of the appendix with subsequent infection. The appendix is a finger-like extension from the caecum, the first portion of the large intestine.

Appendicitis is the most common reason for emergency surgery in children. Up to eight per cent of children seen with abdominal pain will have the condition. It mostly occurs in children between the age of ten and 20 years and has even been reported in children as young as several months old.

Most cases of appendicitis will occur due to a blockage of the appendix inner lining (lumen) by fecal matter, undigested food materials, or swelling of the lymph glands around its opening to the large intestine. More specific, though rarer, causes may include viral infections and intestinal worms.

Appendicitis occurs in school going age children who report abdominal pain initially around the navel, but within hours may localise to the right lower abdomen. They might also convey loss of appetite as the pain persists and parents may notice that the child has fever.

Movements such as jumping, or coughing often worsens the pain and the child will prefer to lie still in bed. Their breathing becomes shallower than normal and abdomen distended especially if the appendix has ruptured.

Many appendicitis cases present differently and the younger the patient, the more challenging it is to diagnose because the child cannot explain their symptoms.

To help in the diagnosis of appendicitis, the doctor often takes blood to the laboratory to assess for signs of inflammation, or infection.

It is the sum of signs, symptoms and laboratory findings that will guide the clinician to make the diagnosis of appendicitis. The blood tests taken may indicate an infection.

However, there are many potential sources where this can arise from and therefore laboratory findings cannot be the only determining factor.

Where there is doubt as to the diagnosis, the doctor may order an ultrasound, or CT scan of the abdomen. Due to radiation exposure from this test, a paediatric surgeon may be called in to assess the child prior to requesting the investigation.

Due to the pain associated with appendicitis, the patient must be given relief medicines such as paracetamol and an anti-inflammatory drug. Antibiotics are also used to counter the infection.