How to Recognize and React to Signs of Appendicitis in Children

Medically reviewed by Karen Richardson Gill, MD, FAAP on March 2, 2016Written by Rachel Nall, RN, BSN, CCRN on March 2, 2016

While the appendix may be a small organ, it can cause big problems if it becomes infected.

Appendicitis is an inflammation of the appendix and occurs when the appendix becomes blocked for some reason. This includes blockage due to hardened stool, infection, or inflammation in the lymph nodes located in the intestines.

According to the Society of American Gastrointestinal and Endoscopic Surgeons, 70,000 children experience appendicitis in the United States each year. The condition affects more boys than girls.

While appendicitis is the leading cause of stomach surgery in children, it can be a serious condition. If the appendix ruptures, bacteria will be released into the abdominal cavity. This can cause severe infection.

According to the Cleveland Clinic, 20 to 30 percent of children experience a ruptured appendix.

Appendicitis Symptoms

Recognizing appendicitis in your little one is tough because your child can’t always speak in full words or describe their symptoms.

Appendicitis usually starts out as pain around your child’s bellybutton. Symptoms your child could experience include:

  • elevated heart rate
  • frequent urination and pain with urination
  • low grade fever
  • poor appetite
  • stomach pain, especially in the lower right abdomen
  • vomiting

According to Cincinnati Children’s Hospital, most children with appendicitis are between ages 8 and 16. However, children under age 5 can get the condition. They can often have more serious effects because they aren’t as able to talk about their symptoms. A child may have noticeable pain when moving, coughing, sneezing, or touching the abdomen.

Sometimes a parent or doctor may think appendicitis is another condition. Some conditions that cause similar symptoms include:

  • urinary tract infection
  • kidney stones
  • severe constipation
  • pneumonia

When to Call Your Child’s Doctor

If you think your child may have appendicitis, it’s very important to see a doctor quickly.

If a child has appendicitis and isn’t diagnosed in 48 hours, the chances that your child’s appendix could burst or rupture increase greatly. Seek immediate medical attention if your child experiences symptoms that could be appendicitis, like stomach pain that progresses to vomiting, poor appetite, or fever.

Your child’s doctor will ask questions about your child’s symptoms. They may also order imaging tests, like an ultrasound or CT scan. Blood and urine tests can also help to make an appendicitis diagnosis and rule out other conditions.

The difficulty with appendicitis is that no one test can definitively say a child has appendicitis. A doctor has to make his best guess based on your child’s symptoms and any test results. Surgery is the only way to definitively determine if your child’s appendix is affected.

What Treatments Are Available for Appendicitis?

Treatments for appendicitis will require surgical removal of the appendix. If your child’s appendix hasn’t burst, they will be given antibiotics and the appendix will require removal.

However, if your child’s appendix has ruptured, they will require appendix removal and irrigation of the peritoneal cavity. This is a larger surgery to ensure the bacteria present inside the appendix don’t travel to other parts of the abdomen and cause a serious infection.

Children whose appendix has ruptured often have to stay at the hospital longer to receive IV antibiotics because the risk of infection is so high.

How to Help Your Child Understand What Is Happening

When your little one needs surgery, it can be difficult to explain the condition to your child.

Because appendicitis often requires emergency surgery, you don’t always have a lot of time to prepare your child. This approach can help your child as much as possible:

  • Explain to your child that they have a problem that must be fixed at the hospital. Words that could cause your child unnecessary fear include “cut you” or “open you up.” It’s important to be honest with your child about treatments, but not create any extra fear.
  • Explain that surgery can fix the problem. Tell your child that they won’t feel pain during the procedure because they’ll be asleep, but that a doctor will wake them up. Otherwise, they may associate being “put to sleep” with the similar treatment of dying pets.
  • Remind your child that the procedure isn’t because they were bad or because of anything they did.
  • Explain that you will be there for your child just as soon as you can and that they will feel better soon.

If possible, provide distractions before and after your child’s surgery. Examples include a new book or toy or visits from a favorite family member.

Outlook for Appendicitis in Children

It’s vital that a child experiencing appendicitis receive medical attention quickly.

While appendicitis rarely is deadly for children, it can be if untreated. Although appendicitis can be tough to recognize, if your child’s symptoms are different from their typical stomach virus, seek immediate medical treatment. In the instance of appendicitis, it truly is better to be safe than sorry. 

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