Appendicitis Health Article

Appendicitis

Inflammation of the appendix.

Appendicitis occurs when the appendix, a 3—4 in (8-10 cm) worm-like projection of the large intestine, becomes inflamed. The inflammation is caused by hardened feces blocking the appendix channel. Inflammation and infection happen within a matter of hours. If the inflamed appendix bursts, the infection could spread to the abdominal cavity, causing peritonitis or a perforation of the intestine. If a young girl suffers an intestinal perforation, she could develop a severe pelvic infection resulting in sterility.

Appendicitis usually attacks young people between the ages of two and thirty, with teenagers the most likely candidates. One hundred and twenty out of every 100,000 children in the United States undergo appendectomies every year. Some medical professionals believe that many of these surgeries are unnecessary and are making efforts to clarify the diagnostic procedure.

Children of all ages frequently experience stomachaches, and it is often difficult to know when the pain is serious. Appendicitis is characterized by a generalized abdominal pain that gradually increases until the pain is localized in the lower right side of the abdomen. The intensity of the pain may prevent the child from moving, standing, or straightening his or her legs. Fever, nausea, vomiting, and/or constipation may also be present.

Infants and toddlers rarely suffer from appendicitis. On those rare occasions, diagnosis is exacerbated by the child's inability to verbalize what he or she is feeling. A lack of appetite, immobility, irritability, moaning, keeping the legs flexed, fever, and vomiting could signal appendicitis.

Regardless of its origin, a severe abdominal pain should never be ignored or dismissed. The child should be seen by a physician immediately, regardless of the time of day. The doctor will gently press for tenseness in the abdominal muscles and tenderness on the lower right side. He or she will probably order a blood test to check for high white blood cell count, a signal that there is an infection in the body. Because acute abdominal pain can be caused by other factors, many physicians will order a laparoscopy or ultrasound to confirm whether the appendix is inflamed.

When a child with acute abdominal pain is admitted to the hospital, the medical staff may decide to keep the child under observation for several hours to confirm whether the child is suffering from appendicitis. While this may be upsetting to parents, especially when they are aware of the dangers of perforations, a recent study found that keeping patients under close observation for several hours was not harmful and was effective in reducing unnecessary surgeries.

In virtually all cases, appendicitis is treated by the immediate surgical removal of the appendix in a procedure called appendectomy. Many physicians are using laparoscopic surgery for this purpose. The recovery period is brief, normally three to five days. The physician will likely prescribe antibiotics to prevent infection. If the intestine has been perforated, antibiotic treatment is essential.

Books

Slap, Gail B., and Martha M. Jablow. Teenage Health Care. New York: Pocket Books, 1994.

Periodicals

Davenport, Mark. "Acute Abdominal Pain in Children." British Medical Journal 312, February 24, 1996, p. 494.

"Observations of Children with Suspected Appendicitis," American Family Physician 47, May 1, 1993, p. 1494.

Policoff, Steven Phillip. "Tummy Aches," Parents Magazine 68, July 1993, p. 101.

—Mary McNulty