Appendicitis in children: what are the signs?

What is an appendicitis?

Appendicite in children is common - around 29,000 UK children visit hospitals with suspected appendicitis every year¹. It's a medical emergency and knowing what signs to look out for is vital.

Appendicitis is when a small organ in the gut, called the appendix, becomes infected and swollen. The appendix is found in the lower right side of the tummy (abdomen) and this is where a lot of children with appendicitis experience pain.

If left untreated, a swollen appendix can eventually burst - known as a ruptured appendix - and spread bacteria and infection through the body. This is very serious, and requires emergency surgery to remove the appendix - a procedure called an appendectomy.

In most cases of appendicitis, spotting the signs early in your child can get them treated quickly, often without problems.

In children and young people, appendicitis is most common between ages 10 to 19². It can also affect younger children, but it's very rare under the age of two. It's not clear to experts why some develop appendicitis and others don't, but a family history of the health problem seems to increase your child's risk.

Appendicitis in children, and particularly very young children, tends to create different symptoms than in adults. These symptoms can also be similar to other health problems, making appendicitis tricky to recognise.

Do: talk to a doctor as soon as possible. Your doctor may want to examine the child in their surgery, but if they feel it is appendicitis they might refer you directly to emergency care - through A&E in the UK - for urgent treatment and to avoid any delays.

Don't: offer your child anything to eat or drink.

Don't: give them medications, unless they are recommended by your doctor.

To confirm suspected appendicitis, your doctor may use:

• Blood tests - to check for signs of infection.

• Urine tests - to rule out other possible health problems, such as infections des voies urinaires (IVU).

• X-rays, ultrasounds, or CT scans (computerised tomography scans) - to see the signs of an appendicitis in the tummy.

If your child has appendicitis, they will need a type of surgery called an appendectomy. This is the only treatment for appendicitis, whether your child's appendix has burst or not.

The procedure involves making a small cut in the tummy and using a small device called a laparoscope to remove the infected appendix. Although this organ is thought to play a role in the immune system³, both children and adults can live perfectly healthy lives without it - around one in 100,000 people aren't born with one at all⁴. If the surgery is complicated, the surgeons may have to do an open surgery which involves a bigger cut - but this is less common.

Recovery time can be quick, and your child may be out of hospital a day after surgery. If their appendix had burst, your child could need to spend longer in hospital while doctors make sure that the antibiotics your child is given before and after surgery have prevented infection in the body.

There's nothing you can do as a parent to prevent appendicitis in children. It all comes down to chance, and is usually caused by a random blockage in the appendix tube. This could happen when:

• Food that's hard to digest becomes lodged.

• Hard poo becomes stuck.

• Glands in the gut (lymph nodes) become swollen.

Your child can't catch appendicitis from someone else.

1. University of Birmingham: Urgent improvements needed in the care of children with suspected appendicitis - study.

2. Gadiparthi and Waseem: Pediatric appendicitis.

3. Science Daily: Appendix may have important function, new research suggests.

4. Samaha et al: Megaloappendix: a case report.