Can a baby have appendicitis? Appendicitis in children and its signs: how to recognize the disease and take timely measures.

Inflammation of the appendix, in other words, appendicitis, threatens a person at any age, and the myth that children are less susceptible to this disease is just a myth - although quite dangerous.

Children's appendicitis - first symptoms

Pediatric appendicitis poses an even greater threat than a similar disease in adults, since children, especially young ones, are the most difficult to diagnose.

Hypothermia or a viral infection can trigger inflammation of the appendix, as well as poor nutrition and weakened immunity by external factors.

To avoid worsening the situation and serious complications, you need to be able to recognize the symptoms of appendicitis in children in time.

Symptoms of childhood appendicitis differ from those in adults, so it is important to realize that even mild discomfort actually means internal inflammation disguised as an upset stomach or other illness.

Early symptoms include the following:

Painful sensations arise suddenly, as if out of nowhere, the baby can even record the time of onset of pain.
The first wave of pain is localized in the area above the navel, moving lower over time. Sharp jerks and dull pain in the upper abdomen are considered an early symptom, but their appearance should prompt you to seek medical help.
The pain is heterogeneous, sharp spasms alternate with periods of dull sensations, aching pain, and a feeling of heaviness. In this case, the pain does not go away, intensifying when walking, sitting or lying on the left, less often - the right side.
The child feels weak, there is nausea and vomiting.
The temperature rises. The indicator may be insignificant - 37-38 degrees, which indicates stable internal inflammation. During exacerbation, the temperature reaches 39 degrees.
Children, unlike adults, do not have problems with stool. This sign will help rule out poisoning, stomach upsets and other diseases with similar symptoms.

Appendicitis most often manifests itself in young children in a similar way. The first symptoms of appendicitis in children and the form of the disease directly depend on the age of the patient.

Forms of the disease: what hides acute inflammation

Surgical intervention recommended by a doctor should not be refused: a ruptured appendix can cause many complications
A child may develop the same forms of acute appendicitis that are typical for adults, namely:

Catarrhal– with swelling of the abdominal mucosa and inflammation occurring at a moderate pace. This form is one of the simplest and most common, affecting up to 80% of children and adolescents.
Phlegmonous– all layers of the appendix of the cecum become inflamed, pus accumulates in the cavity of the appendix, and the surface becomes covered with small ulcers.
Gangrenous– the walls of the appendix are affected by the necrosis process, tissue decomposition begins.
Probodnaya- with a rupture of the appendix wall.

Children, just like adults, can develop chronic appendicitis, but the number of such cases is extremely small.

Age indicators

Signs of the onset of inflammation are different for different ages. They can be determined only by knowing the characteristics of the course of the disease in a given age category.

The risk of developing appendicitis, as well as the characteristics of its symptoms, directly depend on the age of the child. According to the World Health Association, the peak of appendicitis exacerbations occurs between the ages of 9 and 12 years.

Infants are usually not susceptible to this disease., and cases of exacerbation in children under 3 years of age are rare.

The same statistics define diseases of preschool children as 18-20% of all cases of childhood appendicitis.

60-62% of cases are acute inflammation in children 7-14 years old, and only 20% occur in high school age (15 to 18 years).

Symptoms of appendicitis in children 5 years and younger

Nausea, vomiting.
Chills and slight increase in temperature.
Drowsiness, weakness, moodiness; Concern is clearly expressed on his face.
The youngest may experience constipation or, conversely, loose stools.
The child is thirsty, he is pale, his skin is dry.
The baby curls up on one side (most often the right) and does not allow the belly to be touched.

Symptoms of appendicitis in children 10 years old (as well as slightly older and younger)

Single or repeated vomiting, constant feeling of nausea.
The child loses his appetite and his mouth becomes dry.
The temperature rises and there are frequent chills.
The stool, as a rule, is not disordered, but there are complaints of abdominal pain. The pain becomes sharp when pressing on the stomach.

As a rule, it is in in primary school age (6-10 years) up to 70% of cases are diagnosed atypical childhood appendicitis. This means that recognizing the symptoms of appendicitis in children can be difficult; the appendix can be located in the lower abdomen, near the back, in the rectum, in the area opposite to its usual location.

Symptoms of appendicitis in children 12 years old are completely identical to the signs of the disease in adults, but they progress much faster, like all childhood appendicitis, so recognizing the disease in time is very important.

Symptoms of appendicitis in children 15 years of age and older

Nausea and bouts of vomiting.
Pain in the right side of the abdomen below the navel.
Weakness, chills, slight increase in temperature.
Aching nature of pain, which alternates with sharp attacks.
Dry coated tongue.

If such symptoms are observed in a girl, you should find out when the previous menstruation was - often pain of this nature accompanies only a monthly malaise.

Such a set of symptoms is a significant reason to call an ambulance.

According to Komarovsky, the symptoms of appendicitis in children are the same as in adults - nausea, vomiting, weakness, dry mouth, abdominal pain and fever

The famous doctor mainly examines acute conditions caused by appendicitis in children.

Komarovsky identifies the same symptoms as in adults - nausea and vomiting, abdominal pain, fever, dry mouth, weakness.

Wherein Komarovsky focuses on the fact that with appendicitis the pain is constant: it may subside if the child turns from side to side, have a weak aching character, but do not stop.

In children over 4 years old, stomach diseases are often mistaken for appendicitis, and therefore, after the child’s first complaints, you should not panic, but wait at least 1-2 hours and, if the pain does not subside, call an ambulance.

Home help: what should parents do?

At the first signs of acute appendicitis, parents are advised to do the following:

Lay the child down and give him plenty of cool drinks.
Apply a damp towel to the sore spot.
If the pain continues for some time, call an ambulance, not the district pediatrician. In such cases, one cannot count on stability of the condition, and waiting for the doctor to arrive can waste valuable time.
Until the doctors arrive, remember when the child last ate, ask him about the exact nature and location of the pain, and measure the temperature.

In this case, it is strictly prohibited

Giving painkillers - because of them, it will be very difficult for the doctor to make a diagnosis, and this can lead to delaying surgical intervention in acute cases and endangering life.
Applying heat (a heating pad, etc.) to the sore spot will cause the appendix to rupture and cause peritonitis.
Give an enema - in this case, the pressure on the appendix will increase, it may burst.
Giving laxatives - they also provoke premature rupture of the appendix.
Feeding a child will complicate his condition, increase pressure on the inflamed appendix, and complicate surgery, if necessary.

The task of parents and doctors is to diagnose appendicitis in a timely manner and perform surgery on time.

Consequences rupture of the membrane or breakthrough of the wall of the appendix is the most deplorable: toxic masses accumulated in it break into the abdominal cavity, severe intoxication of the body occurs, which leads to complications in the functioning of the heart, liver, kidneys, as well as many other organs and systems.

What's next?

Appendicitis is detected in only 7-10% of children admitted to the hospital with acute pain, so there is no need to be afraid of hospitalization.

But you should prepare for various scenarios, so it is best for parents to accompany their child to the ambulance, regardless of his age.

Upon admission to the hospital, the doctor conducts a general examination, palpation of the abdomen, and prescribes blood and urine tests. Most often, the final verdict is made after an ultrasound.

Rupture of appendicitis is a deadly phenomenon, and only medical intervention can prevent death.

Treatment of appendicitis takes place in a hospital setting; after the operation, the child is advised to rest. Rehabilitation may take from several days to 2 weeks– depending on the characteristics of the organism and the form of the disease.

You will have to follow a diet for some time after the operation. The task of parents at this time is to provide the child with proper conditions and carefully monitor his diet and condition. Complaints of pain or severe anxiety caused by the scar should be discussed with a doctor.

Appendicitis is an acute, unpleasant, but completely curable disease. The main thing is the timeliness of actions. Vladimir Gonchar, Candidate of Medical Sciences, pediatric surgeon, assistant at the Department of Pediatric Surgery at the National Medical Academy, tells what parents should do first.

In children, as well as in adults, the most common indication for immediate surgical intervention is acute appendicitis. The main symptom of this disease is abdominal pain. However, this symptom is also common to other ailments. It can be triggered by intestinal colic or a banal indigestion.

If the baby complains of pain in the tummy or just cries or screams a lot, then you should not self-medicate. In such cases, it is recommended to call a doctor. Self-medication is very dangerous and risky. Without knowing the exact causes of pain, you can cause irreparable harm to the baby’s health. Refusal to visit a doctor or go to the hospital can cost a child’s life.

Know the enemy by sight

Not all parents know what acute appendicitis in children is and why it occurs. This disease refers to inflammation that affects the vermiform appendix of the cecum. It is also called the appendix. This process plays an important role. It is a kind of repository for beneficial bacteria. Without an appendix, people live normally, but their beneficial intestinal microflora is restored more slowly after infectious diseases.

Inflammation of the appendix of the cecum can occur for various reasons:

due to activation of pathogenic microflora;
due to blockage of the appendix with fecal stones (appendicitis for this reason can occur in those children who suffer from frequent constipation) or tumors;
due to foreign bodies entering the appendix (grape seeds, sunflower seed husks, fish or bird bones).

How does inflammation manifest?

All parents must know the symptoms of acute appendicitis in order to call a doctor for their child in time. In children of different ages, the symptoms of this disease may differ slightly. Below are the symptoms of acute appendicitis in children under 3 years of age and after 3 years of age.

Signs of acute appendicitis	Detailed description of symptoms
Signs of acute appendicitis	Children under 3 years old	Children over 3 years old
Onset of the disease	The baby's general condition is deteriorating. He is capricious, cries, screams, becomes inactive, lethargic. Sleep is disturbed and appetite worsens.	Disturbances in the general condition at the onset of the disease are not pronounced. Appendicitis begins with the appearance of pain in the abdominal area.
Stomach ache	The baby can tell about the presence of pain localized in the navel area. In some cases, children do not complain about anything. However, there are always equivalents of pain that can be detected when changing the baby’s clothes or accidentally touching his tummy.	The pain is non-localized and permanent. They intensify gradually, radiating to the navel area. After some time, the pain is clearly defined in the right iliac region and intensifies with movement, sneezing, coughing.
Body temperature	The temperature rises from 38 to 39 degrees.	For a long time, the increase in body temperature is within 37–37.5 degrees.
Vomit	In young children with acute appendicitis, vomiting is usually repeated (3-5 times).	In older children, when the disease occurs, vomiting occurs 1–2 times.
Chair	In most cases, the character of the stool does not change. He remains normal. In rare cases, diarrhea occurs.	The character of the stool remains unchanged. Sometimes there is constipation.

If you look at a child’s tongue, you will see that it is covered with a white coating. This symptom occurs in some children with acute appendicitis, but its presence cannot be used to judge inflammation of the appendix of the cecum. Whitish coating on the tongue may be associated with a completely different disease. This once again confirms the need to visit a doctor.

Another sign by which one can judge the presence of appendicitis is "forced" position sick child. The baby tries to take a position in which the pain subsides a little. Children with acute appendicitis most often lie on their back or right side. When changing position, the pain returns with renewed vigor. It becomes more intense.

First aid for a child with appendicitis

If the baby begins to complain of abdominal pain, or has other of the above symptoms of acute appendicitis in children, then you need to call an ambulance as soon as possible. The sooner the doctor arrives, the faster the operation will be performed (if the diagnosis is confirmed). Then there will be no fear of complications arising. The baby's life will not be in danger.

Before the doctor arrives, parents can alleviate their child’s condition a little. The baby needs to go to bed. You can place an ice pack on your right side. Thanks to the cold, the pain will subside a little. Under no circumstances should a heating pad be applied to a child’s belly. Heat will only intensify the development of the inflammatory process. The appendix of the cecum will rupture and peritonitis will develop.

Parents should not give their child painkillers. They will not help with acute appendicitis. The pain will subside for a short time and will return after a while. It is also forbidden for the baby to take laxatives and do not give enemas.

If the pain has subsided a little, then you should not hope that it will completely go away. You still need to call a doctor. A short-term subsidence of pain is observed with the development of complications.

Treatment

Several decades ago, doctors, when diagnosing inflammation of the appendix of the cecum in patients, were in no hurry to perform surgery, but used conservative methods. Then specialists abandoned these methods of treatment due to complications. Currently, the only way to eliminate inflammation of the appendix of the cecum is surgery.

At the slightest suspicion of acute appendicitis, the child is hospitalized. In the hospital, additional examinations are carried out, the results of which show whether the appendix of the cecum is inflamed or not. Once the diagnosis is confirmed, emergency surgery to remove the appendix, called an appendectomy, is performed.

Surgery can be performed in two ways. The doctor may make one incision on the young patient's abdomen and remove the inflamed appendix. This operation is called an open appendectomy. In modern clinics, specialists make 3 very small incisions, insert a camera and instruments, and remove the vermiform appendix of the cecum. This operation is called a laparoscopic appendectomy. The second method of surgical intervention is the most preferable, since after removal of the appendix the child will recover faster.

Restoring health after surgery

After surgery, the child is discharged on days 8–10. If the operation was performed using a laparoscope, then the baby will be able to go home after 3-4 days. Parents after discharge from the hospital should:

make sure that the baby gets more rest;
free him from physical activity;
give medications as prescribed by a specialist;
take the child to be examined by a surgeon within a certain time;
do not allow your baby to take a bath for a week (showers are allowed);
prohibit sledding and cycling.

The child's diet after appendix removal has some peculiarities. It is important to understand that during the operation the integrity of the intestine is compromised. That is why it is impossible to eat regular food after acute appendicitis in children, as complications may arise.

On the first day after surgery, you should not eat or drink anything. You can only wet your lips with water. The next day, you can gradually introduce food: low-fat chicken broth, rice water, sweet tea. For several days, the baby should eat frequently (5-6 times a day) and in small portions. The most suitable food consistency is warm puree or jelly.

Later, you can add porridge cooked in water, vegetable soups, and fermented milk products with a small percentage of fat to your diet.

The child should not eat or drink:

fish soups;
okroshka;
borsch;
pea soup;
fatty broths;
pickles and smoked meats;
seasonings and spices;
carbonated drinks.

Prevention of inflammation of appendicitis

Knowing the causes of any disease, you can effectively resist it. This is also true for acute appendicitis. You can prevent the development of this disease as follows:

Acute appendicitis, as mentioned above, can occur due to infection. To prevent this from happening, it is necessary to monitor the child’s health and not neglect regular visits to the doctor.
If any illness occurs in your baby, there is no need to self-medicate or give antibiotics. These drugs, when dosed incorrectly, have a detrimental effect on the beneficial intestinal microflora and create an ideal atmosphere for the proliferation of pathogenic microorganisms - the culprits of all inflammatory processes in the body.
Particular attention should be paid to the baby's nutrition. His diet should contain as few difficult-to-digest meat dishes as possible. Let the baby eat food that is rich in plant fiber (whole bread, buckwheat and pearl barley porridge, seaweed, fresh fruits and vegetables). Thanks to such food, the intestines will work better and its motor function will be optimized.
Parents should not use the same oil several times when cooking. Overcooked fat promotes the proliferation of putrefactive microflora in the intestines, which can cause serious diseases.
Small children, unknowingly or accidentally, can swallow the seeds of berries, fruits, fish bones, sunflower seed husks or other foreign bodies. The parents' task is to explain that this should not be done under any circumstances, since foreign bodies can get into the appendix and clog its lumen.
Constipation should not be allowed to occur. If you have difficulty bowel movements, you should consult your doctor. The specialist will prescribe suitable laxatives for the child. To prevent constipation, it is recommended to drink a glass of cool water 30 minutes before meals. The stomach and intestines will prepare for eating.
Children should be taught to lead an active lifestyle. The appendix needs the smooth functioning of the digestive system. This is facilitated by exercise and running. Even ordinary walks will bring noticeable benefits and prevent the occurrence of symptoms of acute appendicitis in children.

In conclusion, it is worth noting that appendicitis is a very dangerous condition. It is impossible to do without surgery. It will protect the child from complications and save his life. There is no need to be afraid of surgery. The operations are quick, and postoperative care for the baby is quite simple.

Acute appendicitis is inflammation of the appendix (appendix). It is located at the junction of the small intestine and the large intestine - usually in the right iliac (lower lateral) region. Parents need to be able to identify the first signs of appendicitis in children in order to go with their child to a pediatric surgeon in time.

How does acute appendicitis manifest?

Due to the prevalence of this disease, classic symptoms are repeatedly described in surgery textbooks. It is typical for adults and children over 10–12 years of age. The patient complains of severe abdominal pain. First they appear in the upper sections - in the epigastric region, discomfort in which is usually associated with stomach diseases. During the first 12 hours of illness, the pain migrates to the right lower abdomen, becomes aching in nature, and intensifies with physical activity. The typical movement of pain is called the Volkovich-Kocher symptom.

Due to unpleasant sensations, a person spares the right half of the abdomen. The pain intensifies when lying on the left side, as well as when trying to lift the straight right leg up from a supine position. Feeling unwell is accompanied by nausea, and one-time vomiting is possible. There is retention of stool and gases. The body temperature rises - in the case of uncomplicated acute appendicitis it does not exceed 38°C. When examining the oral cavity, attention is drawn to a dry, coated tongue.

The surgeon at the emergency room of the hospital on duty, where such patients are admitted after seeking help, will closely examine the abdomen to see if there is asymmetry, retraction or swelling of the anterior abdominal wall, or if the muscles are tense. Only experienced hands will be able to check for additional symptoms by slowly and carefully palpating the abdomen and reliably recognize appendicitis.

Why is acute appendicitis dangerous?

In adults and children over 10–12 years of age, the greatest risk is phlegmonous appendicitis. In this case, the vermiform appendix becomes like a sac, filled to capacity with liquid pus, and can break into the abdominal cavity. If the appendix bursts, peritonitis will develop - diffuse inflammation throughout the abdomen. Then the operation will have to be performed on a larger scale in order to thoroughly rinse the abdominal cavity from pus with antiseptics. A long course of several antibiotics and long hospital treatment will be required.

The child’s body is not able to independently curb the infection and limit inflammation in only one area of the abdominal cavity. Surrounding organs are easily involved - intestinal loops, pelvic organs, liver. However, the most likely complication is a systemic inflammatory reaction (sepsis, popularly known as blood poisoning) due to the immaturity of the immune response. Therefore, the sooner parents suspect something is wrong, the higher the likelihood of a quick recovery.

What are the differences between the manifestations of acute appendicitis in children?

The child's body has some anatomical features regarding the appendix.

The appendix is often located higher than in adults and is more mobile. It may lie closer to the midline of the abdomen, deep in the pelvis, or behind the rectum. Therefore, the place of greatest pain may differ from usual.
In adults, the lumen of the appendix is closed with a special valve that protects against infection from the colon. In children it is not formed.
The appendix in children has the shape of a carrot with a wide base and a narrow end, which opens the gate for the microflora of the colon.
In adults, there is a special fatty tissue inside the abdominal cavity (the greater omentum). When acute inflammation occurs anywhere in the abdomen, it, like a napkin, wraps the sore spot, preventing the infection from spreading to surrounding organs. In children, it is underdeveloped and cannot cope with this function.

In addition, the child’s body reacts more violently to any disease - intoxication is more pronounced, body temperature is higher, changes in the general blood test are more acute.

How to determine appendicitis in children 8–9 years old?

The symptoms of appendicitis in a child of primary school age are somewhat different from those in adults. The most common symptoms are:

abdominal pain – 100%;
vomiting – 80%, usually once;
refusal to eat – 60%;
diarrhea – 10 – 15%.

Symptoms appear in this order, which is also a diagnostic criterion. This is why it is important that parents or the child have a good understanding of how the disadvantage arose and changed over time.

Acute appendicitis in children 5–7 years old and younger

The younger the child, the less mature his defenses are. Children of preschool age, especially those under 3 years of age, tolerate the disease very poorly. As a rule, they are admitted to the hospital in a serious condition, with severe intoxication. Fever reaches high numbers - 39°C or more. Dehydration of the body quickly sets in due to repeated reflex vomiting (in young children, almost any problem from an intestinal infection to pneumonia is accompanied by vomiting). They are also characterized by diarrhea, which is rare in older children.

It is at this age that the doctor experiences the greatest difficulties in diagnosing - after all, the baby cannot talk about his feelings and does not allow himself to be examined. This forces the surgeon to resort to palpation of the abdomen while the child is sleeping. Sometimes sleep has to be induced by injection of special drugs. Due to the difficulties in determining appendicitis in young children, all children under 3 years of age with abdominal pain should be hospitalized in a hospital, where dynamic observation by a surgeon is mandatory.

Symptoms of acute appendicitis can vary greatly depending on the age of the patient and the individual characteristics of his anatomical structure. Therefore, at the slightest suspicion of this disease, you should contact the on-duty surgical hospital. Only the experienced hands of a doctor can determine treatment tactics - observation, immediate surgery, or referral to a specialist of another profile (infectious disease specialist, pediatrician, etc.).

– acute (less often subacute, chronic) inflammation in the appendix (appendix). Appendicitis in children occurs with abdominal pain, one- or two-time vomiting, frequent bowel movements, temperature reaction, decreased activity, and anxiety. Diagnosis includes palpation of the abdomen, rectal digital examination; examination of general blood and urine tests; Ultrasound, radiography or CT scan of the abdominal cavity; diagnostic laparoscopy. Detection of appendicitis requires an appendectomy, preferably laparoscopically.

General information

Some infectious diseases (typhoid fever, yersiniosis, tuberculosis, amebiasis) can independently cause appendicitis. Predisposing and provoking factors may include overeating, a diet low in fiber and high in sugar, constipation, helminthiasis (ascariasis in children), gastroenteritis, and dysbacteriosis.

Classification

According to the morphological classification, simple (catarrhal), destructive appendicitis and appendix empyema are distinguished. In turn, destructive appendicitis can be phlegmonous or gangrenous (in both cases, with or without perforation). Appendicitis in children does not always lead to perforation of the appendix; in some cases, cases of spontaneous recovery occur.

The appendix in children can be located in the right or left iliac region, subhepatic, pelvic or retrocecal space. Recent studies have shown that children may develop both acute and chronic recurrent appendicitis.

Symptoms of appendicitis in children

The clinical picture of acute appendicitis is extremely varied and depends on the age of the child, the location of the appendix, and the morphological stage of inflammation.

The earliest sign of appendicitis is pain, which in the classic case is localized in the epigastric or periumbilical region, and then shifts to the projection of the appendix (usually the right iliac region). With a retrocecal location of the appendix, pain is detected in the lower back, with a subhepatic location - in the right hypochondrium, with a pelvic location - in the suprapubic region. Older children easily indicate the location of pain. The prevailing symptoms of appendicitis in a young child are restlessness, crying, sleep disturbance, pulling the legs toward the stomach, and resistance to examination.

Pain syndrome with appendicitis is almost always combined with refusal to eat. A pathognomonic sign of appendicitis is vomiting: once or twice in older children or multiple times in children. With appendicitis, children may experience stool retention; in young children, as a rule, stools become more frequent and loose with mucus (diarrheal appendicitis), and therefore dehydration can quickly occur.

Body temperature rises to subfebrile or febrile values (38-40°C). For children of the older age group, the “scissors” symptom is typical, manifested by a discrepancy between temperature and pulse. Increased urination (pollakiuria) is usually observed with the pelvic localization of the appendix.

With catarrhal appendicitis, the child’s tongue is wet, with a coating in the root area; with phlegmonous appendicitis - the tongue also remains moist, but its entire surface is covered with a white coating; with gangrenous appendicitis, the tongue is dry and completely covered with a white coating.

Acute appendicitis can be complicated by perforation of the appendix, peritonitis, periappendicular infiltrate or appendiceal abscess, intestinal obstruction, sepsis.

Chronic appendicitis is less common in children than in adults. It is accompanied by recurrent attacks of pain in the right iliac region with nausea and fever.

Diagnostics

Recognizing appendicitis requires a physical, laboratory, and, if necessary, instrumental examination of the child.

Palpation of the abdomen in a child is accompanied by muscle tension and sharp pain in the iliac region, positive symptoms of peritoneal irritation (Shchetkin - Blumberg, Voskresensky). In young children, the examination is performed during physiological or medicated sleep. If diagnostic difficulties are encountered, a rectal digital examination is performed, which reveals overhang and tenderness of the anterior wall of the rectum, the presence of infiltration, and excludes other pathologies.

A general blood test reveals leukocytosis of 11-15x10 9 /l and a shift of the leukocyte formula to the left. A general urine test can reveal reactive leukocyturia, hematuria, and albuminuria. For girls of childbearing age, the examination program includes a pregnancy test and consultation with a pediatric obstetrician-gynecologist.

When performing an ultrasound of the abdominal cavity in children, it is possible to detect an enlarged (more than 6 cm in diameter) appendix and the presence of free fluid in the right iliac fossa; perforation of the appendix reveals periappendiceal phlegmon. In younger children, electromyography of the anterior abdominal wall is used to identify protective muscle tension.

If there is ambiguity in the interpretation of clinical and physical data, the child may need to undergo an X-ray or CT scan of the abdominal cavity. In case of chronic appendicitis in children, fibrogastroduodenoscopy, eccretory urography, ultrasound of the pelvic organs, sigmoidoscopy, coprogram, stool analysis for dysbiosis and worm eggs, and bacteriological examination of stool can be performed for differential diagnostic purposes. Diagnostic laparoscopy, as a rule, turns into therapeutic laparoscopy.

Appendicitis is the fourth most commonly misdiagnosed disease. Especially those who still cannot say exactly where it hurts. Therefore, every mother should know the symptoms of appendicitis in children, so as not to confuse it with it and consult a doctor in time.

There is a misconception that acute appendicitis does not threaten small children - in fact, such a risk exists even in infants, albeit small. The incidence of appendix inflammation increases after 2-3 years. 18-20% of those sick with this disease are preschoolers. Parents of children of this age should be especially wary, because appendicitis in them is very difficult to diagnose. A small child often cannot tell exactly where it hurts, so doctors have to deal with peritonitis (due to a ruptured appendix).

Often appendicitis in children develops due to decreased immunity. A weakened body cannot resist the attack of viruses - the infection penetrates the vermiform appendix and causes its inflammation. Various diseases (sore throat, ARVI, otitis media, etc.) can also contribute to this.

The difficulty of diagnosing acute appendicitis in children also lies in the fact that its symptoms are common to many diseases. And not every child exhibits all of them.

The most accurate diagnostic method is computed tomography (CT). American scientists consider ultrasound diagnostics to be ineffective, especially when it comes to small children, since it makes frequent mistakes.

But it is still important that parents are able to recognize danger on their own. If the child still cannot clearly talk about his feelings, you should be alarmed that he curls up into a ball, lies on his side (usually on the right), tucking his knees to his stomach, knocks his legs, expresses anxiety when changing position, tries not to move, and His facial expression is pained and wary. If you try to feel your belly, your baby will not let you touch it.

Signs of appendicitis in children under 5 years of age

One of the symptoms of appendicitis in a child is vomiting; it can be single or repeated, but in any case it does not bring relief to the child. In young children (under 3 years of age), appendicitis may also cause pain when urinating. Other symptoms of appendicitis in children:

nausea, vomiting;
anxiety, moodiness, drowsiness, weakness;
pallor, dry mouth, thirst;
fever, chills;
sometimes loose stools or, conversely, constipation;
inability to cough, jump, or walk over bumps, or ride in a car without pain;
difficulty walking.

At the same time, some experts argue that the symptoms of appendicitis will not necessarily include changes in stool, vomiting or diarrhea.

If your child can tell you about his feelings, then notice if he has persistent, unexplained (bottom right corner) that lasts more than 24 hours.

If your baby has several of the above symptoms, you should immediately consult a doctor.

Signs of appendicitis in children over 7 years old

There are several ways to determine appendicitis in children over 7 years old, which parents can do before the doctor arrives:

Ask your child to cough loudly - if the pain in the right iliac region intensifies, this may be a symptom of appendicitis.
A sign of appendicitis is also increased pain in the right iliac region when the child turns on the left side from the back.
If a child, lying on his right side, pulls his legs towards his body and the pain decreases, and then straightens his legs and turns on his left side, and the pain intensifies, this may be a sign of appendicitis.
Do not feel the belly with your fingers, this can be very dangerous for the child. To compare pain in the right and left iliac region, only light tapping with the pad of a finger is possible; if the child feels pain on the left side, but not on the right - this can also be a symptom of appendicitis in the child.

Parents can do such self-diagnosis only in order to urgently call an ambulance if appendicitis is suspected.

How to distinguish appendicitis in a child from an intestinal infection

Both with an intestinal infection and with appendicitis, a child may have diarrhea and vomiting, so it is not uncommon for these symptoms to be mistaken for signs of an intestinal infection. Our infographic will help you differentiate appendicitis from an intestinal infection.

Also note that the appendix may be located atypically, then the child will feel pain in other parts of the body. For example:

retrocecal (behind the cecum)- the child feels pain in the lumbar region, radiating to the groin;
with pelvic localization of the appendix- pain manifests itself in the lower abdomen and above the pubis;
with subhepatic localization of the process- pain in the liver area.

Sometimes pain in children can have a rare localization - radiate to the back, perineum and genitals, ureter, stomach, which makes diagnosing the disease difficult.

What not to do if you suspect appendicitis

do not apply a heating pad to the baby’s belly and do not take warm baths - heat accelerates the inflammatory process
do not give your baby an enema, which increases pressure on the inflamed organ
do not give him painkillers (they will complicate the diagnosis) and laxatives (they may cause a ruptured appendix)
do not feed him, you can only give him sweetened water

Remember: If a child experiences abdominal pain, you cannot begin treatment on your own without establishing the cause of its occurrence. Be sure to call a doctor! If you suspect appendicitis in a child, immediately seek medical help. Any delay can lead to appendicitis turning into peritonitis, and the inflamed appendix can burst at any time, with all its contents, along with pus, ending up in the child’s abdominal cavity.