Appendicitis

Appendicitis is a painful swelling and infection of a narrow, finger shaped, hollow structure called the appendix (an organ which serves no purpose in the human body), attached to the large intestine in the lower right side of the abdomen. This condition is very rare in children under three years, and is not commonly found in children under five years. This is more common in older children and young adults, i.e between the age of 10 -20.

Causes

The inside of the appendix is a passage closed at one end with the other end opening into the large intestine. Swelling and infection of appendix occurs when this opening gets blocked. A piece of food or stool can get trapped inside and block the passage.

Symptoms

The first sign of appendicitis is abdominal pain around the belly-button, which worsens and moves to the lower right side of the abdomen. Other symptoms are vomiting, loss of appetite, mild fever, diarrhoea , constipation, limping or bent-over walking. Frequent urination and increased burning while urinating are symptoms if the appendix is not in its usual position.

Symptoms vary with age. In children of 2 years or younger, common symptoms are swollen abdomen with pain, and vomiting.

Diagnosis

Appendicitis is not easy to be diagnosed because of changes in location of the appendix. Generally it is located in the lower right side of the abdomen. The base of the appendix is located in a constant position, while the location of the tip may vary with individuals. In rare cases, it may be located in the lower left side of abdomen. It is quite challenging for even doctors to diagnose, as it is also similar to many other medical conditions. Sometimes, the symptoms are hidden. Before the typical pain of appendicitis, other symptoms may appear, thus making the diagnosis more difficult. In children under 3 years, it is further difficult to diagnose because they cannot tell, where the pain is, or if the pain is moving to the right.

The earlier it is detected, easier it is to treat. Once you suspect the child’s abdominal pain may be due to appendicitis, i.e the pain lasts for more than an hour or two, more severe and different from usual, inform your pediatrician immediately. The doctor may perform many laboratory tests like blood test, urine test, ultrasound scan and X-ray examinations to look for signs that could confirm or rule out appendicitis.

Treatment

Surgical removal of appendix, known as appendectomy, is usually the treatment for cases of Appendicitis. The appendectomy may be an open surgery in the abdomen or laparoscopic, in which a small incision is made in the navel. Appendectomy is a procedure which does not pose great risk. For an open surgery, the patient may have to stay at the hospital for 3 to 4 days or at the most, less than a week.. Laparascopic appendectomy requires in most cases, a hospital stay of just 24 hours.
Antibiotics may give relief from the problem, if the inflammation and infection is mild and confined to a small area. Even in such cases, surgery may have to be performed to remove the appendix, at a later date. To prevent complications, it is important to remove the infected appendix before it ruptures. If at all it gets ruptured, its removal requires the patient to stay at the hospital for a longer period of time, to treat the spread out infection, before performing the surgery to remove the appendix.

If the infected appendix is not removed, it may burst and spread the infection to the abdomen, and an abscess may also be caused near where the appendix has ruptured. In case of abscess formation, it may be treated with a combination of antibiotics and drainage of the pus from the abscess by a small tube. Even after draining out of the pus, there is the possibility of the inflammation recurring. Therefore, the appendix is usually removed, later.

Intravenous fluids and antibiotics maybe given before and after surgery to prevent complications and reduce risks of infection in the wound caused after surgery.

Prevention

Generally, appendicitis cannot be prevented. However, the risk of getting appendicitis can be lowered, if you eat a diet rich in fibre like fresh vegetables and fruits.