Yes, children can get appendicitis; it is the most common abdominal surgical emergency. The condition occurs when the appendix, a small pouch attached to the large intestine, becomes blocked, inflamed, and infected. Prompt evaluation and treatment are required, as a delay can lead to a rupture and increased complications. Appendicitis can affect children of any age, but is most frequent between 9 and 12 years.
Recognizing the Symptoms in Children
The initial sign of appendicitis is often a vague, dull pain that begins around the belly button or in the upper abdomen. Over several hours, this discomfort typically progresses, localizing and intensifying in the lower right side of the abdomen.
Unlike a simple stomachache, the pain is persistent and progressively worsens. A child may instinctively avoid movement, such as walking, jumping, or coughing, because any jarring motion exacerbates the discomfort. Parents might notice the child walking hunched over or lying with their knees drawn up.
Children often experience a loss of appetite, nausea, and vomiting. A low-grade fever usually develops. Some children may also have diarrhea, which can lead to the condition being mistaken for a common stomach virus.
Why Diagnosis Can Be Challenging
Diagnosing appendicitis in young children, particularly toddlers and infants, presents a challenge because they cannot accurately describe or localize their pain. The classic migration of pain to the lower right quadrant is often absent in up to one-third of pediatric cases. Instead, symptoms may be vague, presenting as irritability, lethargy, or diffuse abdominal tenderness.
The appendix’s variable anatomical position can also cause atypical pain, sometimes manifesting in the flank, back, or even the left lower quadrant. These non-classic presentations often mimic other common childhood illnesses, such as viral gastroenteritis or a urinary tract infection.
A delayed diagnosis in younger patients increases the risk of rupture, which occurs more frequently in children under five. Once the appendix ruptures, infectious material spills into the abdominal cavity, leading to a severe infection called peritonitis. For children under three years old, the rate of perforation can be very high, making timely medical attention essential.
Treatment and Post-Operative Recovery
When appendicitis is suspected, the diagnostic process begins with a physical examination and blood tests to check for signs of infection, such as an elevated white blood cell count. Imaging studies are used to confirm the diagnosis. Ultrasound is often preferred in children because it avoids the radiation exposure associated with a computed tomography (CT) scan.
The standard treatment for acute appendicitis is an appendectomy, typically performed under general anesthesia. Surgeons often use a laparoscopic technique, involving small incisions for specialized instruments. This minimally invasive approach results in less post-operative pain and a quicker recovery compared to traditional open surgery.
In some uncomplicated cases caught very early, non-operative management using intravenous antibiotics alone may be an option. Following an uncomplicated laparoscopic appendectomy, children frequently go home within 24 hours. Recovery is relatively short, with a return to school or normal activity often possible within one week.
If the appendix has already ruptured, the surgical procedure is more complex, and the recovery is longer. These children require a hospital stay of up to seven days or more for a prolonged course of intravenous antibiotics. Vigorous activities and contact sports are usually restricted for up to six weeks after surgery.