Appendicitis: Children and Teens

Appendicitis is an infection of the appendix. It affects 7 percent of Americans and is the most common reason for a child to need emergency abdominal surgery, according to the American Academy of Family Physicians. Young people between ages 11 and 20 are most often affected. Most cases occur in the winter months between October and May. A child, especially a boy, may have a greater risk for appendicitis if someone else in the family had it.

The appendix is a small, fingerlike structure attached to the large intestine in the lower right side of the abdomen. Appendicitis occurs when the appendix is blocked by a piece of stool, a foreign body that was swallowed, or swelling from an infection. Bacteria then invade the wall of the appendix. This causes more damage.

If the infected appendix isn't removed, the appendix may leak or burst. This can cause either a localized infection or a life-threatening condition called peritonitis.

There's no way to prevent appendicitis. It is rare in countries where people eat a high-fiber diet, but experts haven't yet shown such a diet definitely prevents it.

Signs and symptoms

The symptoms of appendicitis in older children and teens are abdominal pain, fever, and vomiting. The pain usually begins in the center of the abdomen, around the area of the navel. Later, it may move downward and to the right.

After abdominal pain begins, older children and teens with appendicitis usually develop a slight fever, lose their appetite, feel nauseous, and may vomit. Other symptoms include diarrhea; the need to urinate frequently; a strong urge to urinate; constipation; and, sometimes, respiratory symptoms.

In children younger than age 2, the most common symptoms are vomiting and a bloated and swollen abdomen.

Diagnosis

It can be difficult to diagnose appendicitis. Even experienced doctors aren't able to diagnose it 100 percent of the time. There is no laboratory test for it. X-rays may not be useful. In some cases, CT scans can help pinpoint the condition.

Treatment

Appendicitis is a medical emergency that must be treated surgically. If the appendix is removed surgically before it bursts, complications are rare. The hospital stay is usually two or three days. If the appendix breaks, a longer hospital stay is needed after it's removed.

When to call the doctor

Call your doctor immediately if you suspect your child has appendicitis. This will give your doctor more time to confirm the diagnosis and remove the infected appendix before it leaks or bursts and spreads infection. If you are unable to contact your doctor, go to the emergency room.

If it appears your child may have appendicitis, don't give him or her pain medication or anything to eat or drink. Having an empty stomach speeds preparation for surgery, if needed.