Children's Hospital Colorado


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What is appendicitis?

Appendicitis is the inflammation of the appendix. Sometimes, the appendix will rupture (perforation or bursting) or blood supply to the appendix may be interrupted (gangrene). The best treatment option for a non-perforated appendicitis is removal. 

What causes appendicitis?

Appendicitis occurs when the appendix is blocked, which leads to swelling and interferes with blood flow. Inadequate blood flow then permits bacterial invasion and inflammation, which can ultimately lead to the rupturing of the appendix.

What is the appendix?

The appendix is a small, closed tube attached to the colon, located in the lower right portion of the abdomen. The purpose of the appendix is unknown, although it serves as a collector of waste that is not digestible. The removal of the appendix has no effect on digestion.

Who gets appendicitis?

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

What are the signs and symptoms of appendicitis?

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 of the symptoms, so it's important to seek medical advice quickly if your child demonstrates any of the following:

  • 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 or fullness of the abdomen
  • Loose stools

What tests are used to diagnose appendicitis?

Diagnosis can be difficult, especially in younger children. At Children's Hospital Colorado, our pediatric surgeons diagnose children based on:

  • Symptoms
  • Physical examination
  • Laboratory studies
  • An ultrasound or CT scan (occasionally)

How is appendicitis treated?

At Children's Colorado, pediatric surgeons perform an operation called an appendectomy to remove the appendix using minimally-invasive surgical techniques. That means the surgeons create three small incisions to look inside the body with a camera and perform the removal surgery. This is called a laparoscopic method. Sometimes, surgeons can't perform the surgery this way and instead need to make a larger incision between two to four inches, which allows them to see inside your child's body without using a camera.

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

After the operation, the patient will be admitted to the hospital surgical unit to monitor their recovery. We monitor kids during this time to make sure the infection clears.

How is perforated appendicitis treated?

There are two ways to treat perforated appendicitis. The treatment method depends on the patient's clinical symptoms, physical exam and diagnostic studies. Appendicitis can be treated with an appendectomy as described above. However, sometimes, the contents of the colon spill out into the abdominal cavity because of the hole (perforation) in the appendix. This can cause a very infected and inflamed environment in the abdomen, making it not an ideal scenario for operating.

In this case, the surgeon may decide that it is best to treat the patient with IV antibiotics for several weeks. The patient will get a PICC (peripherally inserted central catheter) line, which is an IV that the patient can use outside the hospital and receive IV antibiotics at home.

About five to eight weeks later when the infection has cleared and the patient is well, the surgeon will remove the appendix.

Why choose Children's Colorado for your child's appendicitis?

Minimally invasive techniques

At Children's Colorado, our pediatric surgeons perform the latest minimally invasive surgeries including laparoscopy, single incision. This approach shortens healing time, and lessens the pain and discomfort of surgery for children.

Your child's care team is pediatric-trained

Children's Colorado 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.

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