Appendicitis in Children

Appendicitis in kids: Can it happen?

Kids can get appendicitis, just like adults. Appendicitis is an infection or inflammation of your child’s appendix. The appendix is a small, tube-shaped organ attached to the large intestine, located in the lower right side of the abdomen.

Appendicitis is an emergency. If your child’s appendix gets infected, they need treatment right away.

How common is appendicitis in children?

Appendicitis affects 70,000 children per year in the United States. It’s most common in kids between the ages of 10 and 18 years. Appendicitis is the most frequent reason for emergency abdominal surgery in childhood.

How do I know if my child has appendicitis?

Abdominal pain in the lower right belly is one of the main signs of appendicitis in kids. The pain often starts around your child’s belly button and moves to the lower right side later. Your child may have difficulty walking, and pain might get worse when they jump or cough.

Other appendicitis symptoms in kids may include:

• Nausea and vomiting
• Loss of appetite
• Fever
• Pain with movement

If you’re unsure about your child’s symptoms, call their healthcare provider.

What causes appendicitis in kids?

The most common cause of appendicitis in kids is a blockage at the opening of the appendix. Other causes may include:

• Abdominal infection
• Digestive tract infection
• Inflammatory bowel disease
• Stool (poop), parasites or growths inside your child’s appendix

Healthcare providers don’t always know the cause of appendicitis in kids. Sometimes, it happens without a clear explanation.

What are the risk factors for appendicitis in children?

There are no known preventable risk factors. But your child may be more likely to develop appendicitis if they:

• Are 10 years of age or older
• Have a family history of appendicitis
• Have cystic fibrosis (experts in some research studies have found a link between cystic fibrosis and appendicitis)

What are the complications of appendicitis in kids?

Left untreated, appendicitis may cause your child’s appendix to rupture (burst open). A ruptured appendix can spread bacteria throughout your child’s abdomen. These bacteria can cause a serious infection called peritonitis. A ruptured appendix may also result in bacterial infection of the bloodstream — a life-threatening condition called sepsis.

How is appendicitis in children diagnosed?

Your child’s healthcare provider will do a physical exam and ask about your child’s symptoms and medical history. They’ll likely need to run tests to get a better understanding of your child’s condition.

What tests will be done to diagnose my child’s condition?

Your child’s healthcare provider may order urine (pee) or blood tests to check for infection. They may also request imaging tests like:

• Abdominal X-rays
• Abdominal ultrasound, which uses high-frequency sound waves to show images of your child’s organs
• CT (computer tomography) scans, which show cross-section images of your child’s body (computed tomography uses a combination of X-rays and computer technology)

How is appendicitis in children treated?

In mild cases, providers may treat appendicitis in kids with antibiotics alone. But in most instances, they’ll need to surgically remove your child’s appendix (appendectomy). Surgeons do this procedure in one of two ways:

• Laparoscopic surgery. A surgeon makes several small incisions in your child’s lower right abdomen. Then, they’ll place a tiny video camera (laparoscope) through one of the incisions and use small instruments to remove your child’s appendix. This type of appendectomy has a shorter recovery time and a lower infection rate.
• Laparotomy (open) surgery. A surgeon makes one larger incision in your child’s lower right abdomen. Providers use open surgery to treat more complicated cases of appendicitis. It has a longer recovery time.

Before surgery, your child’s provider will give them antibiotics to start fighting the infection. When it’s time for the procedure, a pediatric anesthesiologist will give your child anesthesia to help them sleep during surgery. In most cases, it takes about one hour to finish the procedure.

Are there risks?

Overall, appendectomy is a low-risk procedure. But complications can happen after any surgery. If your child’s appendix ruptured, they may have an increased risk of:

• Infections
• Abscesses (pockets of pus)
• Small bowel obstructions

How soon after treatment will my child feel better?

Most children recover quickly after surgery. In most cases, they won’t have any food-related restrictions.

Depending on the severity of their symptoms, your child may need to stay in the hospital for several days following surgery (for monitoring, pain management or to receive additional medications, like antibiotics). However, children who recover well after surgery without significant pain can often go home on the same day.

Kids who had laparoscopic surgery should limit their physical activity for the first three to five days of recovery. Children who had open surgery should rest for 10 to 14 days before engaging in physical activity.

Can appendicitis in children be prevented?

Because healthcare providers don’t always know what causes appendicitis, there’s no way to prevent it. The best thing you can do is call your child’s healthcare provider as soon as you notice symptoms.

What can I expect if my child has appendicitis?

If your child has appendicitis, their healthcare team will start them on antibiotics right away. Then, they’ll run tests to determine the severity of their condition.

In most cases, your child’s provider will schedule surgery within 24 hours of their diagnosis. Following the surgery, they may need to stay in the hospital for several days. They’ll keep you informed every step of the way.

When can my child go back to school?

If your child had laparoscopic surgery, they may be able to return to school in a week. If they had open surgery, they may need another week or two to recover. Your child’s healthcare provider can tell you what to expect.

When should I take my child to see their healthcare provider?

Your healthcare team will schedule a follow-up visit two to four weeks after your child’s surgery. They’ll examine your child’s incisions and make sure their recovery is on track.

In the meantime, call your healthcare provider if your child develops any of the following:

• Fever
• Increasing pain
• Vomiting
• Excessive swelling, discoloration or drainage from the incision

What questions should I ask my child’s doctor?

If your child has appendicitis, you may want to ask their healthcare provider:

• What kind of appendectomy does my child need?
• When can my child go back to school?
• How can I tell the difference between appendicitis and other stomach issues?

What is the most common age of appendicitis in children?

In children, appendicitis is most common after age 10. Overall, you’re more likely to get the condition if you’re between the ages of 10 and 30.