Appendicitis

What is appendicitis?

The appendix is a small, tube-like structure attached to the colon, typically located in the lower right portion of the abdomen. Appendicitis is the inflammation of the appendix. The cause of appendicitis relates to blockage of the appendix. The blockage leads to swelling and interferes with blood flow. Inadequate blood flow then permits bacterial invasion and inflammation. If the blockage is not treated, gangrene and rupture (perforation or bursting) of the appendix can result. The best option for treatment of appendicitis is removal. The appendix serves no crucial function and its removal has no effect on digestion.

Why come to Children's Hospital Colorado for treatment of this condition?

Children’s has a dedicated team of pediatric surgeons and anesthesiologists who serve children exclusively. Our care team is experienced in this procedure and in providing the best care for kids.

What are the signs and symptoms?

The symptoms of appendicitis can easily be confused with symptoms of the flu or other gastrointestinal problems. If left untreated, the appendix can burst and cause a very serious infection. Not all children will experience all the symptoms, so it’s important to seek medical advice quickly if your child demonstrates any of the following symptoms:

• Fever
• Abdominal pain
• Pain around the belly button that may move to the lower right side of the abdomen
• Nausea and/or vomiting
• Loss of appetite
• Swelling of the abdomen
• Loose stools

How is appendicitis diagnosed?

Diagnosis can be difficult, especially in younger children. Appendicitis is diagnosed based on symptoms, physical examination and laboratory studies. Sometimes an ultrasound or CT scan is also obtained.

How is appendicitis treated?

Usually an operation called an appendectomy is done to surgically remove the appendix. The operation can be done by making an open incision, or by using a laparoscopic method, which is more common.

If the surgery is performed laparoscopically the surgeon will use a long thin camera lens called a laparoscope and long thin instruments. Three tiny incisions are made in the abdomen, including one that is hidden in the belly button. The surgeon will insert the tiny camera and laparoscopic instruments through the small incisions and remove the appendix.

To close the incisions, stitches will be placed under the skin and will dissolve over the course of several weeks. Small dressing tapes called steri-strips will be placed over the incision(s).

If the appendix has not burst, then the patient will not require long-term antibiotics and usually can go home in 1 or 2 days. If the appendix has already ruptured, then the infection will require a longer course of antibiotics and recovery will take longer. For a few patients with delayed diagnosis, the best treatment is drainage of the infection (abscess) and removal of the appendix weeks later.

Who gets it, and can it be prevented?

Appendicitis is rare in infants but can occur in children of almost any age, as well as adults. Appendicitis cannot be prevented, but if caught early, treatment is easier and recovery is quicker.