Appendicitis is a treatable medical condition characterized by an infected or inflamed appendix. However, if the problem isn't tended to immediately, usually by removing the appendix during surgery called an appendectomy, the risk of the appendix rupturing, or bursting, is very high. The Johns Hopkins Children's Center (JHCC) reports that in the United States alone, appendicitis is responsible for placing 77,000 children in the hospital each year.
The appendix is a small, long, hollow organ–often described as a pouch or tube–in the digestive system that resembles a finger in shape and size, and that serves no apparent biological function, which is why removing it causes no complications. Located in the right lower area of the abdomen called McBurney's point, it's connected to the colon near the intersection of the large and small intestines.
Appendicitis occurs when the appendix becomes infected or obstructed, which causes it to swell with pus and rapidly multiplying bacteria. Left untreated, the appendix can rupture within one to three days, putting the rest of the body in danger of infection as bacteria spreads, and even death within hours.
Appendicitis is most common among young people aged approximately 10 to 30. Yet, many doctors have difficulty diagnosing it because the signs overlap with those of other conditions, such as the stomach flu. Four reliable symptoms of appendicitis in children, according to JHCC, are fever; stomach pain that originates near the belly button and then lowers to McBurney's point; rebound discomfort (pain or tenderness after removing pressure quickly) in McBurney's point; and more than 10,000 white blood cells per microliters of blood, which signal an infection.
Although lost appetite and nausea and vomiting are frequent signs of appendicitis among adults, JHCC maintains that their presence isn't a reliable predictor of the condition in children. Other symptoms of appendicitis in both groups are diarrhea and a swollen abdomen, with the last especially common among infants, who rarely develop appendicitis.
The longstanding and universal treatment for appendicitis in children is removing the appendix surgically as soon as possible to prevent infection from a rupture. Two forms of surgery are available. The first traditional procedure involves removing the appendix through an incision in McBurney's point with standard surgical tools, while the second uses a laparoscope (a fiberoptic device the width of a pencil, with an attached light and camera) to help remove the organ through a smaller opening that heals faster and scars less.
Treatment differs if the appendix ruptures. In that case, a child still enters the hospital, but she first receives antibiotics to fight the spread of bacteria. If pus accumulates in the abdomen, forming an abscess, doctors may also penetrate the skin to drain the substance before surgery. When infection is under control, which can take anywhere from weeks to two months, an appendectomy is performed.
Ruptured Appendix Symptoms
A child is more likely to experience a ruptured appendix than an adult because parents often disregard children's unique appendicitis symptoms initially–believing they indicate a normal stomachache, for example–which causes delayed treatment. Signs of a ruptured appendix include a very high fever of up to 104 degrees Fahrenheit, dull pain spread throughout the abdomen, a high white blood cell count, vomiting and weakness. When these symptoms are present, emergency medical care is required immediately.