How to determine appendicitis in a child: primary manifestations. Appendicitis in children: how to recognize symptoms in time

Among all the health problems that exist in children that require surgical intervention, appendicitis in children is especially highlighted in surgery. According to statistics, 3/4 of urgent operations are performed specifically to remove acutely inflamed appendicitis. It is interesting that, according to medical reports, school-age children are more susceptible to inflammation, the proportion of which is 4/5, the remaining 20 percent of those sick are still very young.

The main problem of childhood appendicitis, which distinguishes it from the course of the disease in adults, is the rapid development of an acute form, which leads to serious complications and serious danger to life. There is a danger of intestinal necrosis (in particular, the cecum) and the transition of inflammatory processes to other parts of the gastrointestinal tract, for example, to the abdominal part with the subsequent occurrence of peritonitis, which is especially difficult to treat.

Another problem, no less serious in importance, is the difficulty of diagnosing it and timely identifying the existing problem. In children, inflammation can easily disguise itself as ordinary poisoning, in which case it can be difficult for parents to keep track of individual specific abilities. It is important to learn to distinguish between a child’s complaints and to catch the first symptoms of the disease in order to have time to prevent major complications.

Experts usually identify factors that directly cause acute inflammation and factors that are specific provocateurs that significantly increase the risk of disease manifestation. These groups include a large number of different reasons, both natural and caused by improper care of the child and monitoring his health.

The main reasons for the development of appendicitis

The appendix (that's right, not appendicitis, as many people believe) is a small extension of the large intestine. This process in its shape resembles a worm, with which it is usually compared, and ends with a completely blind end. The functions and purposes of this organ in the human body are not yet completely clear, and there are a huge number of assumptions about the functional significance of the appendix. For a long time, doctors promoted the theory of the mandatory removal of this process even before the appearance of any inflammatory processes, but after the idea appeared that this organ could play an important role in maintaining immune processes, this practice did not take root.

The cause of inflammation of the appendix and the development of appendicitis is usually two main reasons, very similar to each other:

narrowing of the process;
blockage of the appendix.

Subsequently, the active development of bacterial flora occurs in the cecum. Among the main reasons for such complete or partial blockage are the following options:

Such a mechanical blocking of the lumen of this same cecum ultimately leads to a disruption in its functioning - mucus begins to be removed with great difficulty, or getting rid of it stops completely, internal pressure increases sharply, the walls become tense, and the mucous membrane noticeably swells. The blood supply process sharply deteriorates, venous blood stagnates, and the same microflora and bacteria that accumulate in the appendix quickly multiply. In children, appendicitis usually becomes inflamed within 12 hours after the process “starts”.

Photo: Appendicitis in children

The development of appendicitis and the subsequent outpouring of pus and accumulated fecal matter occurs rapidly - it usually takes from 1 to 3 days before this process begins.

By the way, usually children under 2 very rarely suffer from the acute form of appendicitis. This is due to a more natural and soft diet at this age, and also in childhood, this appendix is wider and shorter - it is much easier to clean. With age, appendicitis seems to stretch, making it difficult to cleanse. Lymph nodes, which, when swollen, can also clog the appendix, are formed only by the age of 8, when a very large number of cases of exacerbation are usually observed.

Factors that increase the risk of developing appendicitis

Pathogenic microflora is always present in all parts of the intestine, so it can hardly be called the causative agent and cause of the development of inflammation. The reason for the development of inflammation is the creation of a favorable environment for bacteria, in which they begin to actively multiply, many times exceeding the natural quantities usually contained in the body. Another way to sharply increase their number in the appendix is for bacteria to enter there along with lymphatic fluid or already infected blood, which comes from already infected organs that act as foci of infection. Such foci may be located, for example, in the nasopharynx during the development of colds. The development of inflammation can also be caused by individual infections, such as sore throat and otitis media. Other diseases are directly related to appendicitis. These usually include typhoid fever, tuberculosis and other serious infectious diseases.

Experts classify children's appendicitis according to the stages of their development and the severity of the entire disease process. The characteristics of those very negative destructive processes that occur in the body also significantly influence the classification. However, it is worth remembering that all three degrees of severity of the disease are directly related to each other - the simplest cases of the disease, in case of untimely treatment, very quickly develop into much more severe forms.

Uncomplicated appendicitis

Simple appendicitis also called catarrhal. This is a simple disease, usually characterized by barely noticeable thickening of the walls and still very mild inflammation. Such inflammation is the initial stage of a serious illness. It is best, of course, if symptoms are noticed precisely at this stage - in this case, treatment is very easy and in a short time.

Developed inflammatory processes

Destructive appendicitis- second stage of the disease. It is divided into two variants of the course of the disease:

phlegmonous inflammation, which is an increase in the size of the cecum, inflammation of the walls, thrombosis of nearby vessels and other problems;
gangrenous inflammation, characterized by the noticeable development of necrosis of intestinal tissue.

Acute inflammation

Empyema, or third, the most serious degree of inflammation, is an active acute purulent process occurring in the appendage of the cecum.

Features and possible consequences

The last two stages of the disease, the most serious, may be accompanied by rupture of the appendix, but in the case of a childhood illness, such an outcome is completely unnecessary. In children, the integrity of the inflamed organ can often be preserved, which is disrupted only in the case of very prolonged treatment.

It is also worth noting that in some cases there may be unique cases of spontaneous healing or a decrease in the degree of inflammatory processes, but, of course, you should not count on such an outcome. Another option for the development of the disease is the transition of acute inflammation into a chronic version, with relapses occurring from time to time.

Separately, it is worth considering the peculiarity of the localization of inflammation in the child’s body. The peculiarity of childhood appendicitis is that it can be located in any part of the abdominal cavity - under the liver or even lower in the pelvic space, in the left and right parts and other areas, which significantly complicates the process of diagnosing inflammation not only for parents, but also for doctors .

Signs of appendicitis in children: main symptoms and diagnosis

Appendicitis in children is one of the most dangerous diseases in terms of frequent misdiagnosis. The problem is especially relevant for those children who cannot describe their own pain in detail. While doctors dismiss existing dangerous options, inflammation increases and progresses, eventually reaching a truly dangerous stage. Parents also face a difficult task - in children, the symptoms of appendicitis are very similar to the course of many other diseases, so it is sometimes impossible to immediately suspect something is wrong.

Photo: Signs of appendicitis in children

However, there are some classic developments of the disease in children, which are accompanied by the most common symptoms at different ages:

from the very beginning, acute pain occurs in any part of the abdominal cavity, for example, near the navel, which then usually concentrates in the right side; It is important to remember that if the child’s forced position helps reduce pain (for example, on the back or right side) or, on the contrary, noticeably aggravates it (for example, on the left side), this can be a very clear indicator of progressive inflammation; Of course, in young children these signs can only be understood intuitively, while older children describe their own sensations in more detail;
vomiting also often accompanies inflammation, but it is important to remember that in the case of appendicitis, after vomiting the child never gets better, but with the same poisoning, on the contrary, vomiting at the end leads to some relief;
the inflammatory process in children most often occurs with a noticeable increase in temperature, and this property gradually becomes less pronounced with age - the older the person, the less significant the increase in temperature is; in older children, fever necessarily accompanies the later stages of inflammation with possible complications;
by the appearance of the tongue one can judge the course of inflammatory processes - usually, if the disease develops, a noticeable white coating appears on it; in the most difficult cases, the entire surface is covered with plaque, in the initial stages - only the root; with the development of necrosis, persistent dryness of the tongue is also observed;
Separately, various problems with stool can occur - very young children develop diarrhea, and with age, the disorder acquires the character of constipation; if the intestine is located close to the urethra, difficulties may occur in this area.

We must not forget about the specific symptoms that appear if there is an atypical location of the burned cecum:

The lower back hurts especially severely if the inflamed area is located in the retroperitoneum;
the perineum and groin area are affected in the pelvic position; separately, problems with urination and excretion of feces with a large amount of mucus are especially common;
the right side hurts if appendicitis is located along the liver, in which case the entire right hypochondrium may be affected.

In children of three years old, they usually focus on other signs of an anatomical or intuitive nature:

extremely rapid progression of inflammatory processes, and, therefore, the external course of the disease itself;
general anxiety, sleep disturbance, appetite disturbance, the same vomiting, characteristic of all ages;
sudden changes in temperature, up to 39-40 degrees;
frequent bowel movements and urination that are clearly painful for the baby;
The child most often allows himself to be examined normally and often intuitively pulls his legs towards his stomach, as if trying to distract himself from the pain.

Even at the slightest suspicion of pendicitis, you should immediately consult a doctor and conduct a full examination. Otherwise, the latent form of the disease and its unknown course can lead to the spread of infection throughout the body and even to the development of peritonitis, which already poses a danger not only to the well-being, but also to the life of the child. You can even first confirm your suspicions by palpating the abdomen - the localization of pain and tense muscles quite clearly characterize the picture, although such signs may not always appear in the initial stages of inflammation.

The doctor must carry out the following stages of the examination:

palpation of the abdomen and its external examination;
blood and urine tests to determine the level of bacterial organisms in them;
Additionally, stool analysis and endoscopy are performed;
Ultrasound of the abdominal cavity;
X-ray or CT scan of the abdominal cavity, allowing you to visualize the problem;
For teenage girls, an examination by a gynecologist is required to rule out possible additional problems or errors in diagnosis.

The main way to treat appendicitis in both children and adults is direct surgery. The operating method is chosen depending on the stage of development of inflammation.

Closed laser operations are carried out in the initial stages, when the disease can be diagnosed almost immediately, or in cases where there is no danger of premature rupture of the inflamed organ. In this case, instruments and a video camera are inserted into the body through small incisions, after which the child will remain under the supervision of specialists for about a week, although recovery after such a procedure is not particularly difficult.

Photo: Treatment of appendicitis in children. Operation

Open surgery is required if the inflamed appendage bursts. It is removed, after which the entire abdominal cavity is cleaned of bacterial microflora and mucus. feces and other contaminants. A large number of antibacterial drugs are necessarily used. During the recovery period, the child is forbidden to eat or even drink, which sometimes causes some difficulties. It is very important to monitor the symptoms of any potential complications, which may indicate, for example, a purulent abscess and other negative consequences.

It is important to remember that even with the slightest suspicion of appendicitis, heating pads, enemas and other home self-treatment options are prohibited. Laxatives and other drugs are also prohibited; in the most critical cases, only painkillers are allowed.

An important action that parents must take is to call an ambulance, which will help determine the child’s condition.

The inflammatory process in the final part of the cecum is called appendicitis. This disease occurs in people of all ages. It can easily affect young children and teenagers. Without timely medical care, this disease can be fatal or cause serious complications.

Causes and provoking factors

The causes of appendicitis can be completely different external factors. As a rule, inflammation occurs after hypothermia or decreased immunity. A child can also get this disease if he has chronic diseases of the digestive system.

Poor nutrition with low-quality foods can also easily cause an inflammatory process in the intestines. The intake of large amounts of unrefined fiber can provoke acute inflammation of the final section of the cecum, causing disease.

The most rare cause of appendicitis may be congenital intestinal pathologies. In this case, the baby is already born with altered intestines. This can be an individual shortening of the length, as well as multiple bends or bends of the wall. In this case, appendicitis can also develop quite often when exposed to external factors.

Why timely diagnosis of appendicitis is important can be seen in the following video.

Species

Like any inflammatory disease, appendicitis can occur in several forms. If the disease occurs for the first time and occurs with fairly pronounced clinical symptoms, then this form is called acute. If, after the treatment provided, in which the appendix was not removed, appendicitis occurs again, then this form of the disease is called chronic. It requires removal of the appendix in order to prevent future dangerous symptoms.

All acute forms of the disease can be divided into several types:

Catarrhal form of the disease. In this case, the disease proceeds as calmly as possible and, as a rule, does not cause life-threatening complications. In this form, the inflammatory process invades the wall of the cecum and provokes the appearance of the first specific symptoms of appendicitis. If surgery is performed on time, the baby is completely cured.
Phlegmonous form of the disease. It is already more dangerous, it can cause life-threatening complications. With this variant of the course of the disease, severe inflammation of the intestinal wall already occurs. Thrombosis of the vessels supplying the cecum is also possible.
Gangrenous form. The most dangerous variant of the course of the disease. During inflammation in this course of the disease, the intestinal wall dies. This option can cause life-threatening complications for the child: a breakthrough in the wall and the release of the entire contents of the intestine into the abdomen (with the formation of peritonitis and shock). In this case, urgent surgery is required to remove the organ. Only this measure will help save the baby’s life.

First signs

It is better for every mother to be familiar with the manifestations of this disease in order to easily recognize a dangerous problem at home. Identifying this disease is not always easy.

Parents often think that the appendix is on the right side. However, this is not entirely true. The vermiform appendix is very mobile. Anatomically, it can be located not only on the right. In 20% of babies it is on the left side. In every 9 out of 10 children, it can even be located near the navel.

The onset of the disease can be completely nonspecific. In many children, the onset of the disease occurs under the guise of a common cold. In the first days, the body temperature rises to 37 degrees, weakness appears, and, less often, chills. The child becomes lethargic, eats poorly, and refuses to play. Habitual activities do not bring him any joy. The baby is sleepy, lies down more often, and spares his tummy.

During the first two days, parents often cannot suspect appendicitis and begin to give the child medications for fever, as for the flu or acute respiratory infections. However, despite the treatment started, no effect is noticed. Meanwhile, the child is getting worse. Symptoms that are more specific to this disease appear. Body temperature rises to 38-39 degrees. The child complains of abdominal pain.

In the first two days, pain begins in the area near the navel. Then it gradually goes down to the groin or to the right half of the body. The pain increases significantly when changing body position. The child may experience nausea or even vomiting. However, these are not necessarily symptoms characteristic of appendicitis.

It is important to note the nature of pain with appendicitis. It may be different. Some babies feel pain moderately, without sudden increases. Others - spasms. In this case, the pain first intensifies, then subsides a little. As a rule, in most cases, bowel problems do not occur. Only children with chronic intestinal or stomach diseases may sometimes experience constipation or diarrhea, but these are nonspecific signs of the disease.

Does it appear the same?

In children of different ages, the course of the disease can vary significantly. According to the latest scientific studies, the peak incidence occurs at the age of 10 years, 12 years. In most cases, infants are not at all susceptible to this disease. Children under 5 years old also get sick relatively rarely.

According to statistical medical data, every fifth person with appendicitis is a child aged 6 or 7 years. More than half of all cases of inflammation of the appendix in children occur in primary and secondary school age. As a rule, these are children from seven to 14 years old.

Since the body of a three-year-old child is noticeably different, for example, from the body of a nine-year-old schoolchild, the course of the disease is also different.

Up to five years

Children of this age are characterized by a gradual development of the disease. Body temperature rises relatively low. Quite often, nausea or vomiting may occur. Children often become capricious, eat poorly, and are very restless.

Children under three years of age often experience thirst and all the symptoms of dehydration. Skin and lips become dry. The baby begins to spare the tummy and does not allow him to examine or touch it. In the first two years of life, babies may also often experience constipation or very loose stools.

Up to ten years

In children, body temperature rises to 37.5-38 degrees. In more severe variants of the disease - even up to 39 degrees. Babies often feel sick, but vomiting or bowel movements usually do not occur.

Characterized by severe abdominal pain. When examining or trying to touch the tummy, it intensifies significantly. The child tries not to lie on the injured side, as this significantly increases the pain.

Teenagers over 12 years old

In many cases, appendicitis at this age follows almost the same scenarios as in adults. In the first couple of days, characteristic pain appears in the umbilical region with a gradual movement to the right half of the abdomen or to the groin. Often body temperature rises to 37-37.5 degrees. The pain is often paroxysmal, without severe spasms.

Abnormal bowel movements, nausea or vomiting are not typical. But quite often signs of dehydration appear. The child's appetite decreases or is practically absent, and weakness appears.

All symptoms of the disease are nonspecific. It is often quite difficult to determine appendicitis on your own. In this case, you should definitely seek professional medical advice from a pediatrician.

Diagnostics

The appearance of the first symptoms of the disease is not a 100% method of diagnosis. Only a doctor can confirm appendicitis. To do this, the doctor will first examine the baby and carry out all the special medical tests that will allow the disease to be confirmed with sufficient accuracy at home.

To make an accurate diagnosis, you need to take the child to the hospital. He will undergo several tests without fail. A clinical blood test will show whether there is inflammation, as well as the severity of the disease.

In difficult cases, when the diagnosis of appendicitis is quite difficult to establish, doctors resort to additional diagnostic methods. First, the baby will be examined by a surgeon. The child may then have an ultrasound examination of the abdominal organs. This test will show the condition of the appendix and whether there is inflammation.

Before performing surgery to remove the appendix, doctors will take blood from the baby for additional tests. This is necessary for future anesthesia and surgery.

Treatment methods

Inflammation of the appendix is a surgical disease. In most cases, once the diagnosis is confirmed, the inflamed organ must be removed surgically. Home mode in this case is extremely dangerous. Without timely qualified medical care, the baby may even die.

During your stay in the hospital, your baby will undergo all the necessary urgent diagnostic tests and tests. Once the diagnosis is confirmed, surgery to remove the appendix will be performed in a fairly short time. Postponing surgery is very dangerous in many cases. This can lead to the development of peritonitis or septic shock in the baby.

Recovery after surgery usually lasts 10-14 days. At this time, the baby is prescribed a special diet that spares the gastrointestinal tract. Vitamin therapy will help quickly restore the child’s immunity. All physical activity (and especially visiting sports clubs) are allowed one month after the operation, not earlier. In this case, all physical activity should be introduced gradually. Lifting heavy objects over 5 kg is strictly prohibited (for three months).

Possible complications

The most common complications of appendicitis include:

Development of peritonitis. If medical care was not provided in a timely manner or the disease proceeds in an aggressive and dangerous form, inflammation of the peritoneum may occur. This significantly worsens the prognosis and requires urgent surgery.
Septic shock. In some cases, appendicitis can also be caused by bacteria or viruses. With reduced immunity, the child may develop shock. In this case, blood pressure drops sharply and the pulse quickens. The baby may even lose consciousness. The development of shock is a life-threatening event.
Breakthrough of the wall of the cecum. If the disease is suspected late (or surgery is not performed in a timely manner), due to severe inflammation, intestinal contents may spill into the abdominal cavity. This is a very dangerous condition that can cause peritonitis or septic shock in a matter of minutes.
Shock (due to dehydration). With severe symptoms of intoxication, severe symptoms of dehydration appear. This leads to a heavy load on the heart and blood vessels. The baby may develop tachycardia or arrhythmia.

Complications from appendicitis can occur in almost any course of the disease. If the baby has chronic diseases, has a weakened immune system, or is receiving corticosteroid hormones, the risk of complications increases several times.

Principles of nutrition

After surgery to remove the appendix, while still in the hospital, the baby will be prescribed a special gentle diet. For the first few days, babies are allowed to eat only pureed and low-fat foods. All dishes are prepared using gentle methods. As a rule, the menu only includes porridge, pureed slimy soups and steamed lean meat.

Upon discharge from the hospital, the attending surgeon gives recommendations to the mother about what the baby can eat after the operation. It is recommended to follow the therapeutic diet for one to two months. This will allow the inflamed intestinal wall to quickly recover, and the weak child’s body will be strengthened.

Basic principles of therapeutic nutrition after surgery:

Small portions of food. Babies should eat up to six times a day (in moderation). The volume and quantity of food is measured according to age tables. Overeating during the postoperative period is very dangerous! This can lead to re-inflammation of the intestines and provoke complications.
Lack of very fatty, fried foods. All products containing smoked foods or marinades are also excluded. All food should be only slightly salted. Spicy and overly bright seasonings are prohibited. In the first month, you can add only a little table salt to your food. From the fifth week after the operation, you can add a little ground black pepper. You can add sugar, vanilla or a little cinnamon to sweet dishes.
During the first two weeks after surgery, fresh fruits and vegetables can be eaten only after heat treatment. Eating raw fruits with peel is strictly prohibited. Apples and pears are delicious baked with a little cinnamon or powdered sugar. Try to limit large amounts of unrefined fiber in your child's diet.
Introduce fiber gradually. The basis of the baby’s diet in the first two weeks is well-cooked porridge, as well as meat products or poultry. You can use fish.
Choose a gentle cooking method. Leave frying and grilling until the baby is completely recovered. The most correct cooking methods are boiling or cooking in a slow cooker or double boiler.
For proper carbohydrates, use well-cooked porridge. You can add some pasta or noodles no more than 1-2 times a week. In the first two weeks after surgery, prepare dairy-free porridge. Adding dairy products can lead to stool problems and diarrhea.
Sufficient water intake. After severe dehydration, the child’s body really needs water (to replenish lost reserves). Add fruit and berry fruit drinks, compotes, tea and plain boiled water to your child’s diet.

Prevention

It is almost impossible to insure yourself against the occurrence of appendicitis. At any age, this disease can take you by surprise. However, if the following conditions are met, you can slightly reduce the likelihood of appendicitis in your child:

Treatment of appendicitis should be timely and fast. Delay in providing medical care for this disease is unacceptable! Only emergency surgery will help cure the disease in time and save your baby’s life. You can suspect the disease on your own, but you should definitely call an ambulance or a pediatrician.

See the following video for what abdominal pain in a child may indicate.

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 a fingertip 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.

Appendicitis in medicine is the inflammatory process of the appendix. The disease is a dangerous pathology because it is difficult to diagnose, and if not treated in a timely manner, dangerous complications develop. The symptoms of appendicitis in children differ from the symptoms of the disease in adults.

Inflammation of the appendix can occur in children of all ages. The symptoms of the pathology are similar to those of many diseases of the gastrointestinal tract, including infectious ones. Therefore, diagnosing the disease is difficult even for experienced doctors.

In addition, the symptoms of the disease in children depend on their age. For example, in infants a symptom is diarrhea, while in adolescents, on the contrary, constipation often occurs.

A feature of appendicitis in children is its rapid development. If you ignore the signs of the disease, dangerous complications may arise.

The first signs of appendicitis

The first symptom of the pathology is acute pain in the navel area.

Which part of the abdomen it moves to depends on the location of the appendix:

The usual placement of the appendix is pain in the lower right side;
subhepatic location - pain in the hypochondrium on the right;
pelvic location - the suprapubic part of the abdomen hurts, the child often urinates, diarrhea with mucus may occur;
retrocyclical localization (behind the rectum) – lumbar pain.

The classic manifestation of appendicitis is pain in the umbilical area, which extends down the right side of the abdomen. Near the navel it is usually dull and aching, and after moving down it becomes intense, sharp and stabbing.

With atypical locations of the appendix, other symptoms may occur (discomfort and pain in the groin area, problems with urination, tense abdomen). In such cases, a dangerous complication is a gangrenous form of inflammation of the appendix.

Signs of inflammation of the appendix in children are also considered:

refusal to eat food;
difficulty walking;
white coating on the tongue;
sharp pain in the abdomen when jumping, coughing, or driving.

Regarding temperature, it rises to different levels depending on age. The highest is with appendicitis in children, low-grade fever (not higher than 38 degrees) - in adolescence. In this case, symptoms of respiratory diseases are not observed: cough, nasal congestion, runny nose, pain and redness in the throat.

A child with appendicitis may feel nauseous and often vomit, which does not bring relief. Sometimes the pathology, along with the above symptoms, can manifest itself as loose stools and constipation.

Another sign of appendicitis: if you put the child in a supine position with his knees bent, then when you gently press on the right side, the pain eases. If you suddenly release your fingers, you will experience increased pain.

If such symptoms are observed, it is better to show the child to a doctor.

How to recognize a seizure in children under 3 years of age?

It is especially difficult to determine pathology in children because they are not able to express their feelings. Appendicitis at this age is the most dangerous due to its sudden onset and rapid development. However, due to the anatomical features of the intestines and proper nutrition, the appendix rarely becomes inflamed in young children.

Usually at this age, with appendicitis, the child is very restless: he presses his legs to his stomach, tries to lie on his left side, curled up. When the abdomen is palpated, children usually cry.

Signs of inflammation of the appendix at this age include:

moodiness;
refusal to eat;
pulling the legs towards the stomach;
anxiety;
cry;
frequent regurgitation;
sleep disturbance;
vomiting (usually repeated);
nausea;
pain when urinating;
rapid pulse;
decreased activity;
pale skin;
hyperthermia - up to 40 degrees;
dry mouth;
pallor of the tongue;
loose stools with mucous discharge;
general weakness.

In some cases, a child under three years of age may experience diarrhea or constipation. It is also important to note that children who are fed breast milk usually have a temperature of no higher than 37.5 degrees.

Signs of appendicitis in children 5 years old

Preschool children may not talk about abdominal discomfort for a long time because they do not pay attention to mild pain.

Symptoms of appendicitis in children aged 3 to 5 years include:

The temperature in children of this age with appendicitis rises to 38.5-39 degrees.

Symptoms of pathology in a school-age child

In schoolchildren, appendicitis manifests itself with the same symptoms as in adult patients.

Typical signs of the pathological condition include:

vomiting (can be double or single);
increased low-grade fever (up to 38 degrees);
loss of appetite;
disturbed sleep;
increased pain when bending forward;
dry tongue and white coating on it;
pain in the lower abdomen.

Normal stools are usually observed. However, sometimes constipation or diarrhea occurs.

Experts say that most often at this age, atypical symptoms develop with an inflamed appendix:

back pain;
discomfort in the epigastric zone;
pain in the rectum.

The location of the pain depends primarily on the location of the appendix.

Signs of appendicitis in teenagers

According to statistics, inflammation of the appendix occurs more often in them than in younger children.

One of the symptoms of the disease in adolescence is considered to be “toxic scissors” syndrome. In this case, there is a discrepancy between the rapid pulse and body temperature.

Symptoms of appendicitis in children aged 12 to 17 years are:

abdominal pain (localization depends on the location of appendicitis);
increase in temperature;
one-time vomiting;
constipation;
weakness;
coating on the tongue.

Treatment of appendicitis in children

Appendicitis is treated surgically - an appendectomy is performed. For this purpose, two surgical methods are used:

removal of the appendix in an open manner (through an incision in the abdominal cavity);
laparoscopy (use of a special surgical instrument).

The operation is performed under general anesthesia. It lasts from half an hour to sixty minutes.

After surgery, in order to prevent the development of complications, the child is prescribed antibacterial drugs.

The wound after incisions and laparoscopy is treated daily with antiseptic solutions until healing and a sterile bandage is applied to it.

In addition, after surgery it is necessary to follow a diet. Immediately after surgery, you can give your child a little water to drink, starting with a drop and increasing to a teaspoon.

The next day, low-fat kefir or weak broth is allowed.

Possible complications

If you ignore the signs of pathology in children, life-threatening complications can quickly develop. A simple form of the disease rapidly develops into destructive appendicitis (gangrenous and phlegmonous).

Serious consequences of appendicitis are:

appendicular peritonitis;
intestinal obstruction;
internal bleeding;
perforation of the appendix wall;
appendicular abscess;
sepsis.

These consequences can be fatal if not diagnosed and treated promptly. Sometimes a periappendiceal infiltrate develops, which becomes chronic. With timely consultation with a doctor and treatment, the risk of developing these complications is reduced several times. In this case, the prognosis is favorable.

Frequent diarrhea and vomiting with appendicitis in a child can result in dehydration.

Postoperative complications include the appearance of pus on the sutures, problems with the abdominal organs, and subphrenic abscess.

Thus, appendicitis in children of different ages can manifest itself differently. Symptoms of the pathology are similar to other diseases and poisoning. Inflammation of the appendix in childhood has its own characteristics and is fraught with the rapid occurrence of severe complications. Therefore, if signs of inflammation of the appendix appear, you should not hesitate, but call emergency help.

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 - widespread 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 redirection to a specialist of another profile (infectious diseases specialist, pediatrician, etc.).