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11 November 2009
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Toddler

Appendicitis

Dr Trisha Macnair

Appendicitis is the inflammation of the appendix, which is a small extension off the side of the large bowel. It's more common among children than adults.


In animals, the appendix plays a vital role in the breakdown and digestion of vegetable matter. But it appears to be redundant in humans and we can live quite happily without it.

What causes it?

Appendicitis may be caused by infection or by something (for example, a hard lump of faeces) blocking the appendix.

It's not clear why the infection occurs but one theory suggests that bacteria normally found in the gut invade through the wall of the appendix, as a result of weakness in the body's defences, to cause inflammation and infection.

Who's affected?

Appendicitis can occur at any age but it's common among children.

What are the symptoms?

The child typically describes colicky pain in the centre of the abdomen that comes and goes. The pain then shifts to the iliac fossa (lower outside edge of the abdomen) on the right side and becomes worse.

Loss of appetite and sometimes vomiting occur, although this is rarely severe. There may be constipation or diarrhoea.

The child will be feverish and may show a dry, furry tongue, flushed face and lie still, taking shallow breaths because of the pain.

Appendicitis should be considered whenever there's severe or persistent abdominal pain

Sometimes the symptoms aren't typical and appendicitis should be considered whenever there's severe or persistent abdominal pain - get medical advice.

The diagnosis is easily mistaken and nearly half those operated on are found not to have appendicitis. It may be confused with food poisoning, mesenteric adenitis (inflammation of lymph nodes in the abdomen) and urinary infections.

What's the treatment?

Call your doctor if your child has severe pain, and don't give them anything to eat or drink. Urgent surgery to remove the appendix (called an appendicectomy) is needed before it bursts or perforates.

If it bursts, infectious pus is spilled into the abdomen, which can lead to peritonitis (inflammation of the lining of the abdomen). This can result in long-term damage, such as infertility in women.

Antibiotic treatment, painkillers and sometimes intravenous fluids are offered.

Most children recover from having their appendix removed within a few days. Complications such as an abscess or peritonitis occasionally occur. Call your doctor if you're worried about your child after the operation.

This article was last medically reviewed by Dr Rob Hicks in November 2007


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