Appendicitis in children and its signs: how to recognize the disease and take timely measures. How to identify chronic or acute appendicitis in children

Appendicitis is called inflammation of the appendix. This is the part of the large intestine that is located in the lower right side of the abdomen. This is his standard location. It can also be localized in the liver, in the pelvis, or located mirror-like on the left side of the abdomen.

The appendix is an atavism, that is, an organ that does not carry any functions, but its inflammation brings a lot of inconvenience and discomfort.

Appendicitis most often develops in children over 9 years of age.

Causes of appendicitis in children

The causes of appendicitis in children are the blockage of the intestinal lumen and the development of pathogenic flora in it. Several factors contribute to this.

A foreign body can block the lumen of the appendix. Most often, these are fruit or fish bones, as well as seeds. Another cause is worms and excessive growth of lymphoid tissue. Constipation can also contribute to inflammation. The reason for this is fecal stones that accumulate in the appendix.

Obstruction of the appendix or its abnormal curves cause the accumulation and development of pathogens in it. They enter the appendix with the blood, often after an infectious disease, causing swelling.

Dysbacteriosis, overeating, and consumption of large amounts of sweets can also cause appendicitis..

First signs in children and adolescents

Appendicitis develops abruptly and can strike a child anywhere.

The first symptoms of the disease are:

pain - pain first appears in the epigastric region. Then, as the disease develops, they move lower. The final location of localization is the lower right side of the abdomen. At first, the pain is mild and insignificant. But due to the intensification of the inflammatory process, its intensity increases, and, in the end, it becomes unbearable;
children are restless, cry, refuse to eat;
When palpating the abdomen, a sharp pain occurs. Children jerk away the hand of an adult who is trying to explore the abdominal wall, as this brings them discomfort. It is difficult for babies to squat, positioning on the right side is painful;
fever is not a pathognomonic symptom for appendicitis. It may not exist at all, or, on the contrary, a fever of up to 40° develops.

If you experience these symptoms, consult your doctor. With the help of simple tests, he will be able to confirm or refute the diagnosis of acute appendicitis. Otherwise, if you ignore these signs, they can develop into serious complications.

Symptoms of appendicitis in children

Appendicitis rarely develops in children under 2 years of age. This is due to the feeding habits of babies, as well as the fact that the amount of lymphoid tissue in the appendix is insignificant. The lumen with which it communicates with other parts of the digestive tract is quite wide and difficult to close.

But unfortunately, inflammation of the appendix can also occur in infants. In this case, diagnosing the disease is difficult. Symptoms of appendicitis in infants are manifested by a violation of the general condition of the baby. He becomes capricious, his appetite decreases, his favorite toys do not attract him, and the child cries in his arms.

Vomiting appears, and the younger the child, the more frequent it becomes. Diarrhea may also occur. Vomiting and loose stools lead to dehydration of the child. He becomes pale, lethargic, breathing is rapid and shallow. The temperature may be raised to 38° or absent.

The complexity of the disease is that a small patient cannot tell that he has a stomach ache.

Symptoms of appendicitis in children 2-3 years old similar to those of infants. But at the same time, a small patient of this age may react to painful palpation of the abdomen. Appendicitis in such children occurs rapidly and quickly develops into peritonitis. Symptoms of inflammation of the appendix at an early age also include vomiting, diarrhea with mucus, and fever. The pain intensifies on the first night of the disease, so children sleep poorly, screaming and tossing and turning.

Children 4-5 years old They can already tell that their stomach hurts. Of course, they still cannot indicate a clear localization, but they point to the stomach in the navel area. Children become lethargic, refuse to eat and play, and squatting causes pain. The forced position is noteworthy: they lie on their left side, with their legs pulled to their stomach. This reduces muscle tension, and therefore pain. Vomiting, like diarrhea, may not occur.

Appendicitis in children 6-7 years old easier to recognize. They can indicate a little more accurately the location of the concentration of pain, which is constant, without paroxysmal contractions.

Smart little guys can cheat. When they see a doctor, they can say that nothing hurts them, just so they don’t have to be taken to the hospital. Therefore, it is worth paying attention to the child’s position: it is difficult for him to straighten up, he walks or lies crooked, and cannot turn on his right side. This causes pain..

The first symptoms of inflammation of the appendix in children 8-9 years old may go unnoticed. The child may experience minor pain without paying attention to it. But only when it becomes unbearable will he point to it, and the child can already clearly determine the location of the pain. With the typical location of the appendix, the pain is concentrated on the right side of the lower abdomen. If the appendix is located under the liver, then pain occurs in the right hypochondrium.

The presence of a process in the pelvis causes pain in the lower abdomen, behind the cecum - lumbar pain and painful urination. The appearance of the scissors symptom is characteristic: at normal or slightly elevated temperatures, the heart rate increases significantly. Children complain of nausea. There may be one-time vomiting.

Starting from 9 years of age, the critical age for the development of appendicitis begins.

The cause of inflammation in children 10-11 years old is a strong proliferation of lymphoid tissue in the appendix, which clogs it. It should be noted that in younger children the development of the disease is more rapid: very little time passes from the onset of pain to peritonitis.

In older children the disease progresses more systematically. For example, pain and other symptoms of appendicitis in adolescents 12-13 years old occur several days before the onset of complications.

Symptoms and course of the disease in adolescents 14-15 years old, as well as 16-17 years old, proceed in the same way as in adults.

Kinds

The classification of appendicitis is quite simple. It can be acute or chronic.

Symptoms of acute appendicitis develop quickly against the background of complete well-being. The acute form is divided into:

appendicular colic— the inflammation is small, subsides after a few hours;
catarrhal appendicitis- ordinary acute inflammation of the appendix;
phlegmonous- characterized by purulent inflammation, the appearance of ulcers. May rupture;
gangrenous- develops as a consequence of thrombosis of the vessels of the appendix. Its atrophy and decomposition occurs. The child's condition is serious.

The cause of the development of chronic inflammation of the appendix is previously developed acute appendicitis, which ended without surgical intervention.

Symptoms of chronic appendicitis in children– this is periodic, not pronounced pain in the abdomen on the right after physical activity or poor nutrition. They pass quickly. Nausea, bloating, and upset bowel movements also occur. Periods of remission may be followed by relapses. The symptoms of the disease are the same as for acute appendicitis.

Diagnosis of appendicitis

In recognizing an illness, the symptoms of the disease play a leading role.

The appearance of severe, prolonged pain in the abdominal area is a reason to consult a doctor.

Inspection. There are several main symptoms that are a sign of appendicitis:
- Shchetkin-Blumberg symptom- gently press on the appendix area on the abdominal wall and quickly tear off the hand. If the reaction is positive, sharp pain occurs;
- Rovsing's sign- press on the lower abdomen on the left. Without removing your hands, the second one pushes the abdominal wall a little higher. The pain radiates to the right iliac region;
- Voskresensky's symptom- run your hand along the stretched shirt along your stomach. Painful sensations, again, appear in the abdomen on the right.
Rectal examination.
Blood analysis detects an increase in leukocytes, or rather neutrophils. Red blood cells, white blood cells, and protein appear in the urine.
Ultrasound abdominal cavity and pelvis, CT.
Laparoscopy.
For teenage girls, examination by a gynecologist is mandatory..

Do not try to test these symptoms yourself unless you have the proper experience.

Treatment

If you suspect the development of appendicitis in a child, Do not give him painkillers until he is examined by a doctor. The pain will subside, the baby will stop complaining about it, and the inflammation will progress. This will lead to a protracted course of the disease and undesirable consequences.

Enemas and laxatives are also contraindicated. Do not use a heating pad with either hot or cold water.

Don't delay your visit to the doctor. If your child does develop acute appendicitis, the only treatment option is surgery.

The fastest and least traumatic method is laparoscopy. The surgeon makes several punctures and, using an endoscope and camera, removes the appendage. Children recover quickly after such an operation, and after a week they are discharged, of course, subject to compliance with the regime and diet.

For complicated forms, open surgery is used.. Before it, infusion and antibiotic therapy is carried out. After such an operation, the recovery period takes a little longer.

Appendicitis can have complications. These include:

peritonitis develops when the process ruptures. The contents of the intestines spill throughout the abdominal cavity, causing further development of the infection. Children experience increased body temperature, severe abdominal pain, and gassy intestines. As the process intensifies, the pain disappears. There is clouding of consciousness;
appendicular abscesses, infiltrates, bleeding. They develop 5-7 days after surgery. Their manifestations are acute pain and hyperthermia;
sepsis- the infection enters the blood, generalized inflammation of the entire body occurs;
suppuration of a postoperative wound. In this case, antibiotic therapy is prescribed, the sutures are removed, the wound is treated and drainage is installed;
intestinal obstruction.

There is no specific prevention for this disease. It is important to monitor your child's nutrition. It should be balanced and contain enough fiber to prevent constipation. It is important to carry out the prevention and treatment of helminthiasis, as well as infectious diseases.

Appendicitis is a childhood disease. If you seek help in a timely manner, it can be easily eliminated and the child will recover quickly.

If its symptoms are neglected, inflammation of the appendix can have serious consequences, delaying treatment and removing the child from active life for a long time.

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.).

Appendicitis is one of the most common pathologies of the abdominal cavity, requiring emergency surgical intervention, which develops due to inflammation of the appendix.

Types of appendicitis

Depending on the nature of the disease, appendicitis is divided into two main types - chronic and acute. Clinical and anatomical classification of inflammation of the appendix in children includes the following types:

the perforated form of appendicitis involves rupture of the wall of the appendix and the outpouring of its contents into the abdominal cavity itself;

empyema of the appendix - accumulation of pus in the lumen of the appendix;

gangrenous appendicitis - accompanied by necrosis of the tissues of the walls of the appendix;

phlegmonous appendicitis - inflammation of all layers of the appendix, while its surface is covered with fibrin spots, pus accumulates in the cavity;

catarrhal appendicitis is the simplest and most common form of pathology. It is accompanied by hyperemia of only the mucous membrane of the appendix, swelling, and accumulation of serous exudate in the abdominal cavity.

Symptoms of appendicitis in children

Acute appendicitis can develop in children at any age, but the disease most often occurs between 5 and 14 years of age, while in boys the pathology occurs 2 times less often than in girls. Compared to adults, the symptoms of appendicitis in children are somewhat different, which is due to the poor development of the lymphoid tissue of the appendix and some differences in the structure of the appendix. In children, the appendix is quite often localized behind the cecum (retrocecal) and subhepatic, which causes a special picture of the disease.

Characteristic signs of appendicitis in a child:

increase in body temperature to high levels;

signs of anxiety (crying, refusal to eat, sleep disturbances);

abdominal pain of various localizations (depending on the location of the appendix);

urinary disturbance;

bloating;

bowel dysfunction (diarrhea, constipation);

increased heart rate (tachycardia).

In children, appendicitis develops suddenly and has rapidly increasing symptoms. As in adults, the child develops sharp aching pains in the epigastric region, which gradually descend to the place of typical localization, in the right iliac region (with a typical location of the appendix).

Spanish scientists conducted a study of three thousand cases of acute appendicitis, during which it was found that in 40% of cases of admission to the hospital, the patient had consumed fried sunflower seeds or chips the day before; such cases were especially often recorded in adolescents under the age of 14 years.

Symptoms of an atypical location of the appendix:

pain in the liver area – with subhepatic localization of the appendix;

pain above the pubis and in the lower abdomen - with pelvic localization of the appendix;

pain in the lumbar region, radiating to the groin - with retrocecal localization of the process (behind the cecum).

In some cases, pain in children may have a rather rare localization - radiate to the stomach, ureter, genitals, perineum, back, which creates additional difficulties for diagnosing the disease.

Children with inflamed appendicitis quite often take a forced position, in most cases this is lying on the left side with the legs pulled up to the stomach (by reducing the tension of the mesentery and peritoneum, the pain becomes moderate). In addition, the child often prohibits touching his stomach, which greatly complicates the examination, so it is much easier to carry out the examination when the child is in a state of medicated or physiological sleep.

Small children cannot independently indicate the presence of pain, so they become restless - they refuse to sleep, refuse food, scream, cry. In moments of calm, the baby prefers to lie without moving, freezing in one position. There is an increase in body temperature to 38 degrees (in small children the temperature may be higher), tachycardia is noted, a white coating is present on the tongue, and the face becomes red. In older children, there is a so-called “scissors” symptom, when the temperature does not correspond to the pulse rate.

Signs of appendicitis in a child

One of the signs of exacerbation of appendicitis in a child is vomiting, which can be repeated or one-time, and in any case it does not bring relief to the child. In children under 3 years of age, one of the symptoms of appendicitis may be pain when urinating.

During the examination of a child with suspected typical appendicitis, a positive response has most of the symptoms that are characteristic of the diagnosis of appendicitis in adults: the Rovsing, Sitkovsky, Razdolsky, Shchetkin-Blumberg symptom. With retrocecal localization of appendicitis, pain and tension in the abdominal muscles upon palpation are mild, and the Shchetkin-Blumberg symptom may have a negative result. With pelvic appendicitis, the main clinical picture may be somewhat blurred, but a rectal examination becomes more informative, during which the infiltrate is palpated.

If a child has abdominal pain, it is forbidden to carry out independent treatment without first establishing the cause of its occurrence. It is imperative to call a doctor. For children over 7 years old, there are several ways to suspect appendicitis, which parents can do with extreme caution before the doctor arrives:

If a child in a supine position on the right side, when pulling the legs towards the stomach, feels a weakening of pain, and when straightening and turning over to the left side, the pain intensifies, this may indicate acute appendicitis.

Also, a characteristic symptom of appendicitis is increased pain in the right iliac region when the child turns over to the left side from the back.

When coughing, pain in the right iliac region intensifies, which is one of the symptoms of appendicitis.

Feeling the baby's abdomen on your own is not allowed, as this can cause significant harm. To compare the pain in the left and right iliac regions, you can only lightly tap with the pad of your finger, and if the child feels pain on the left side, but not on the right, this may also be one of the symptoms of appendicitis.

Such self-diagnosis is allowed only in order to immediately call emergency help in case of serious suspicion. If the diagnosis of acute appendicitis is confirmed, emergency surgery is indicated. This is a relatively simple surgical intervention, after which in most cases the child is discharged within a week.

American scientists consider ultrasound to be the most ineffective method for diagnosing appendicitis, especially when diagnosing children, since this method leads to frequent errors, so they propose replacing it with a more informative CT scan. However, CT scans are accompanied by radiation, which, with frequent exposure, increases the risk of cancer (especially leukemia and brain cancer), and this risk is higher in children than in adults. But still, with an uncertain diagnosis and symptoms in the case of acute appendicitis or cerebral hemorrhage, computed tomography can save the child’s life, so it is important to correctly assess the risks.

Factors that provoke the development of appendicitis

Factors that can trigger inflammation of the appendix include:

anatomical features of the location of the appendix;

dysfunction of the gastrointestinal tract;

infection in the appendix;

penetration of foreign bodies into the appendix (rarely).

Hereditary predisposition and the connection between inflammation of appendicitis and physical activity or the child’s lifestyle have not been established.

If appendicitis is suspected, do not give your child painkillers, as their effects may complicate diagnosis. Also, under no circumstances should you warm up the child’s belly using a heating pad or other devices, as this will increase inflammation and lead to a worsening of the child’s condition.

Differential diagnosis of appendicitis in children from other diseases

Differential diagnosis of acute appendicitis in children is carried out with the following diseases:

intussusception;

scarlet fever, chickenpox, hepatitis, rubella, measles (also accompanied by abdominal pain);

pneumonia;

urological diseases;

coprostasis;

gastrointestinal diseases;

acute respiratory viral infections (ARVI).

Respiratory infections in young children can be accompanied, like appendicitis, by abdominal pain, fever, and vomiting. However, ARVI occurs with characteristic changes in the mucous membranes of the throat and nose, the presence of nasal discharge and symptoms of conjunctivitis. A distinctive symptom when a child has inflammation of appendicitis is abdominal syndrome - passive tension of the abdominal muscles and pain on palpation.

Pneumonia may be accompanied by abdominal pain that mimics appendicitis. With this development of the disease, the dynamics of the process are important. With pneumonia, increasing shortness of breath, cyanosis of the nasolabial triangle are observed, after some time moist rales and weakening of breathing appear, which are not characteristic of appendicitis. The diagnosis is confirmed by X-ray examination. On an x-ray of the lungs, the signs of pneumonia are clearly expressed.

Otitis in a child (especially a small one) can also copy the picture of appendicitis. Children sleep poorly, cry, and are restless. However, with otitis media, the child’s abdomen remains painless, and there is no passive tension in his muscles. While pressing on the tragus of the ear causes a new attack of anxiety and crying in the child.

Intussusception, compared to appendicitis, has more pronounced symptoms: bloody discharge from the rectum, sharp pain in the abdominal area. On palpation there are no symptoms of peritoneal irritation or abdominal muscle tension. Confirmation of the diagnosis of intussusception is achieved by x-ray examination of the abdominal cavity.

Article prepared by:

All children may experience pain due to indigestion, the development of an infectious disease, or simple constipation. However, such sensations also appear during attacks of appendicitis. Pathology can occur in both acute and chronic forms. Parents need to know the symptoms of inflammation of appendicitis, which manifests itself in children, since such a disease can lead to serious consequences. Their therapy can be lengthy and unpleasant for the child. Most often, when diagnosing such a pathology in children, emergency intervention is necessary. Pediatric surgery is used very often for appendicitis in children. In practice, only 3% of cases of disease development can be managed without surgery.

Inflammation of the appendix in a child requires immediate surgical intervention

In this article you will learn:

Forms of pathology

There is not only an acute, but also a chronic form of the disease, which not everyone knows about. The first differs in several types of appendicitis in children:

Appendicular colic. This is a mild inflammation of the appendix. It usually goes away within a few hours.
Catarrhal or simple. In this case, inflammation of the appendix occurs superficially, the tissues are not destroyed.
Destructive. It is divided into two more types - phlegmonous and gangrenous. The first is characterized by purulent plaque and ulceration of the mucous membrane on the appendix. Gangrenous appendicitis occurs due to thrombosis of blood vessels in the appendix. The shoot becomes dark green with an unpleasant odor. At the same time, the general condition of the child is quite serious.
Complicated.

Catarrhal appendicitis is the simplest and most common form of pathology, accompanied by damage to the mucous membrane of the appendix

With chronic appendicitis, attacks of pain and all the symptoms inherent in the acute form periodically recur, but in a less pronounced form. However, they are often short-lived, and the doctor who arrived on call notes only mild pain when applying pressure in the iliac region on the right. To diagnose the cause of appendicitis in children in chronic form, an inpatient examination is required. For this purpose, doctors of related specialties are also involved. This form of pathology does not occur very often.

The functions performed by the appendix have not been fully elucidated, and therefore the causes of appendicitis in children are only speculative. It is believed that the appendix becomes inflamed due to exposure to pathogenic microflora, as well as blockage of the opening leading from the intestine to the appendix. Such a lumen can be blocked by foreign bodies, for example, seed husks, fecal stones, growing lymphoid follicles (they form it), as well as helminths. At the same time, microorganisms that live in the intestines remain in the appendix itself.

The chronic form of the disease is characterized by short-term pain syndrome

Microbes can be introduced into the appendix together with lymph or blood. This assumption is made due to the fact that the disease often manifests itself after illness. This is an acute respiratory infection, sore throat or otitis media.

Sometimes the appendage becomes inflamed after infectious diseases such as tuberculosis or yersiniosis (infectious lesions of the gastrointestinal tract).

Early symptoms

Before finding out how you can determine appendicitis in a child, you should first understand why the pathology occurs in the first place. The disease develops due to inflammatory processes occurring in the so-called vermiform appendix (appendix), extending from the cecum. It is located in the initial part of the rectum. The symptoms of the disease that appear are also characteristic of other pathologies. Therefore, it is necessary to understand how the stomach hurts in children with appendicitis.

Often appendicitis in children develops after a sore throat or acute respiratory infection.

The first symptom of the disease is pain in the abdomen. Initially they are localized near the navel or slightly above it. At first the pain is barely noticeable. This symptom moves lower over time and spreads to the right side. At the same time, the pain becomes much stronger.

The child's condition worsens significantly. Weakness, lethargy appear, and the temperature rises. Sometimes nausea occurs accompanied by vomiting. Children become capricious and refuse to eat even their favorite foods. When the abdomen is felt, children experience severe pain and may scream or start crying. The temperature rises, but not always, so this manifestation is not the main sign of pathology.

An increase in body temperature is one of the characteristic signs of pathology

Having noticed the unusual behavior and condition of the child, you need to try to feel his stomach and find out exactly where the pain occurs. With appendicitis, the pain intensifies when coughing or laughing. Therefore, if sharp unpleasant sensations occur during such actions, you must immediately call a doctor. You should not hesitate to get medical help, as the disease can develop into peritonitis. Another serious danger is that the inflamed appendage can burst and its contents will flow into the peritoneal cavity.

Parents, of course, are interested in at what age appendicitis can be detected in a child. Medical statistics claim that acute appendicitis is possible in completely different children's age groups. However, more often than in very young children, its manifestation is possible from five to fourteen years. Moreover, girls suffer from it twice as often as boys.

The main danger with appendicitis is the development of peritonitis

Main symptoms

The symptoms of acute appendicitis in young children differ from adult patients in a number of features. They are due to both the structure of the appendix and the still weak development of lymphoreticular tissue. In children, the inflamed appendage is often located behind the cecum. In this case, the pathology proceeds in a unique way. To know how to diagnose appendicitis in a child, it is necessary to identify the main signs of the disease. Among them:

Pain localized in different parts of the abdomen. This is due to the location of the appendix.
Showing anxiety. This can be expressed by sleep disturbances, moodiness and refusal to eat.
Rising temperature. Often it changes to very high levels.
Constipation or, conversely, diarrhea.
Flatulence.
Nausea and vomiting.
Difficult or painful urination.

A child with inflammation of the appendix behaves restlessly and is capricious.

In children, the pathology occurs suddenly and has increasing symptoms. The aching pain that appears begins mainly in the epigastric region, then it descends towards the right side. This is all typical for the normal location of the process.

With other locations of the appendix, pain appears in other places, which is reflected in the table.

Sometimes pain occurs in the back or genitals, and sometimes in the ureter. This makes diagnosing the disease very difficult. With appendicitis, children cannot show where it hurts. Therefore, they constantly cry and scream, stop eating, and often even sleep. When the child can be calmed down, he often lies in one specific position and does not move. Tachycardia is noted, and a white coating appears on the tongue.

Often, children with the development of pathology experience problems with urination

It is not known exactly why appendicitis occurs in young children. However, you need to know the fact that the disease always manifests itself spontaneously, at an arbitrary moment.

In children under 5 years of age

Symptoms of appendicitis in children aged 2-3 years include moodiness, refusal to eat, poor sleep and low activity. At this age, children cannot always understand where exactly they are hurting; it seems to them that unpleasant sensations appear throughout the abdomen. In children under 3 years of age, the strongest reaction can be seen in the first night's sleep after the onset of inflammation. During this period, they may constantly wake up and scream. And the pain will intensify when bending over or getting dressed. Children also experience nausea and vomiting. The skin becomes pale, the patient asks to drink more often. Disorder of stool and chills appear, the temperature rises. If several symptoms occur at once, you should urgently consult a doctor.

Some children with appendicitis lose their appetite

The disease rarely occurs in children under 2 years of age due to the special structure of the intestines. The diet of children is also important in this regard.

Suspicious symptoms of chronic appendicitis in children under five years of age are dull pain felt on the right side in the iliac region. They often appear after the child runs or takes part in outdoor games, and in some cases simply as a result of sudden movements.

The peculiarities of appendicitis manifested in children include the fact that typical clinical symptoms of the acute form of the disease appear only in 30% of cases. The rest are accompanied by atypical syndromes.

In children under 2 years of age, pathology develops in rare cases

Children 6-10 years old

If the child is already 6 years old, then, as a rule, the signs of the disease will be similar to the symptoms that appear in adults. However, it is not always possible to make the correct diagnosis immediately. Since children at this age may be frightened due to fear of surgical intervention. That is why they often tell lies that their stomach has stopped hurting.

In children 8-10 years old, the first signs of appendicitis are morning abdominal pain, high fever, and nausea. If there is sudden pressure on the abdomen, the child experiences very severe pain. Appetite decreases. The stool is usually normal, but sometimes there is constipation, less often - diarrhea.

The first symptoms of an attack of appendicitis in children are sharp pains, similar to lingering tremors. But they can manifest themselves in aching attacks. In some cases they go away, but not for long. Often the pain intensifies when walking, lying on your side or sitting.

Adolescent girls experience abdominal pain before menstruation, which is also characteristic of appendicitis.

Symptoms of appendicitis in children 5-9 years old are basically the same as in adults. Young patients also complain of pain (sometimes even in the back), they feel sick, and the temperature often rises significantly.

For children 11-15 years old

Symptoms of appendicitis in children 11-12 years old correspond to those described earlier. However, their pain is already more pronounced. At the initial stage of inflammation, children of this age feel only discomfort and calmly attend school or hang out with their peers. But the condition may worsen within a few hours.

It should be borne in mind that some of them have already begun the process of puberty. When a teenage girl experiences strong sensations in the abdomen on the right, a suspicion of appendicitis in the child immediately arises. In this case, it is imperative to find out the date of your last menstruation before the arrival of the medical team. Before menstruation, similar pain is likely. This is precisely the distinctive feature of the symptoms of the disease in adolescents.

Diagnosing pathology in young children is very difficult

Symptoms of complications

Complications of appendicitis in children are determined by increased proliferation of bacteria in the appendix. At the same time, mucus secretion increases significantly, edema develops in the intestinal wall, as well as venous stagnation. This contributes to the necrosis of the process. His wall is torn. This break, called a perforation, causes pus or feces to leak into the peritoneal cavity. This manifestation is called peritonitis.

It is also possible the formation of abscesses in the peritoneum at a short distance from the appendix, intestinal obstruction or sepsis. In the case of the development of this generalized pathology from the appendix, microorganisms, together with the bloodstream, are carried to other organs. Ulcers form in them.

If a child, in a supine position on the right side, feels a decrease in pain when pulling his legs towards his stomach, it can be assumed that he has appendicitis

Diagnosis of appendicitis in children is difficult at a young age. In this regard, many parents delay seeking medical help. This attitude can lead to postoperative complications. These include not only problems with wound healing, but also problems arising directly in the peritoneal cavity. This complication in children is very dangerous and can cause death.

It becomes easier to identify symptoms of appendicitis at home in children aged 7 years, since the child is already able to indicate the place where the pain is localized. However, if you suspect inflammation of the appendix, you should under no circumstances delay calling a doctor. There are some tips to help identify the disease:

Coughing. If during this action discomfort is felt in the lower abdomen, this may indicate appendicitis.

You can place a cold compress on your baby's stomach until the doctor arrives.

If light but prolonged pressure on the site of pain leads to a decrease in pain, then this is another sign of possible inflammation of the appendix.
While lying on the right side, ask the child to tuck his legs a little. Reduced pain indicates appendicitis.
Determine the state of the tongue. Most often, when the appendix becomes inflamed, dehydration begins. This leads to dry tongue.

These are all diagnostic methods that can be performed independently without harming the child.

Children should not be given painkillers before doctors arrive. This will weaken the spasm, but will not allow doctors to conduct a full preliminary diagnosis.

The video details inflammation of the appendix in children:

How to rule out other diseases

Any experienced doctor knows how to check for appendicitis in a child. There is no point in doing a full diagnosis on your own. This can only lead to pain for the child, and without the proper experience and skills, it will be difficult to distinguish inflammation of the appendix from other gastrointestinal diseases.

Regardless of what signs of appendicitis appear in children, it is not necessary to do a lot of research to determine the acute form. To do this, you only need two fluids - urine and blood. However, similar outcome rates are possible for other diseases. These may be problems with the kidneys (inflammation due to kidney stones), pathologies of the biliary tract or helminthic infestations. In some cases, radiography or ultrasound may be performed.

Appendicitis can be mistaken for other pathologies of the digestive system

The temperature with appendicitis in children in some cases remains normal. This also needs to be remembered.

If there is a suspicion of inflammation of the appendix, it is advisable to place the child on his back and call emergency help. If possible, it is advisable to take the child to the hospital yourself. Self-help efforts can cause harm. The only recommended action while waiting for the doctors to arrive is to apply a cold compress to the abdomen.

Hello, my name is Vasily. For 7 years now I have been helping people with intestinal problems, working in the first private clinic in Brno. I will be glad to answer your questions about the article in the comments; you can ask our doctors other questions on this page.

The appendix is a part of the large intestine that is shaped like a worm and ends in a blind end. Appendicitis is inflammation of the appendix. When a baby has a stomach ache, many parents attribute this condition to overeating or something else. But do not discount the possibility of inflammation of the appendix. How to determine appendicitis in a baby, what symptoms and signs “give away” this disease, what to do when inflammation is detected, we will tell you further.

How to determine appendicitis in a child - symptoms of acute and chronic appendicitis in children under 3 years of age and older in the table

Signs of appendix inflammation are similar to symptoms of other diseases in children. However, there are a number of characteristic symptoms specific to appendicitis. According to the nature of inflammation, appendicitis can be acute or chronic.

Symptoms of acute and chronic appendicitis in children under 3 years of age and over 3 years of age

Baby's age

Signs of acute appendicitis

Symptoms of chronic appendicitis

Up to 3 years

Acute appendicitis is characterized by a sudden attack of pain in the right side of the abdomen (iliac region). Children under 2 years of age occasionally suffer from acute appendicitis.

With chronic appendicitis, the pain is not so sharp, but there may be relapses, after which the pain subsides again. Children under 3 years of age may feel lethargic and their body temperature rises to 39 degrees. The pain is initially localized in the navel area, and then can be felt in the right side. Kids at this age cannot clearly say where exactly the pain is felt the most. Because of this, it is impossible to diagnose at home. Therefore, you need to immediately contact a specialist at the first signs of the disease.

Over 3 years old

In children over 3 years of age, acute appendicitis is easier to identify, since the main feature of such inflammation is sharp and restless pain. Children mainly complain of constant pain in the right side of the abdomen.

· Children clutch their stomachs (lie in the fetal position in bed).

· Temperature rises.

· Touching the stomach causes pain in children.

· Inflammation is often accompanied by vomiting and nausea at the same time.

In case of acute appendicitis, you should immediately call an ambulance and not give any painkillers.

Chronic appendicitis is a more “cunning” and sophisticated inflammation. Parents may not immediately identify obvious symptoms. The baby usually becomes lethargic, loses his appetite, and his temperature rises to 38-39 degrees. Children may talk about abdominal pain, but it is not pronounced. In chronic appendicitis there are:

· Nausea.

· Chronic nagging pain in the abdomen. Sometimes the pain may intensify and then subside.

Often, seeing the above signs, parents think about an infectious disease, but they need to palpate the baby’s tummy, and if he reacts to finger movements and screams in pain, he should go immediately to the hospital to make an accurate diagnosis.

Types of appendicitis in children: description of the clinical picture of different forms of the disease in the table

Forms of appendicitis in children

Form	Description
Catarrhal	Uncomplicated appendicitis (simple). With this form of inflammation, the walls of the appendix thicken slightly, but the inflammation is not severe without tissue destruction.
Phlegmonous	With this form, suppuration of the appendix occurs (the surface of the appendix becomes covered with purulent plaque). Mucus and pus can also be localized in the cavity of the appendix.
Gangrenous	A dangerous form of inflammation. Occurs due to thrombosis of the vessels of the appendix. It is characterized by a foul odor and dark green color of the appendix. A child with this form is in serious condition.
Perforated	The most unfavorable form for the life of a baby and even an adult. It is characterized by the release of the contents of the appendix into the abdominal cavity (rupture of the appendix).
Infiltration	Progression of the inflammation process with an increase in infiltrate and signs of acute peritonitis.

What tests and examinations are needed to diagnose appendicitis?

When a baby is admitted to the hospital with suspected appendicitis, he must undergo a sufficient number of tests to determine an accurate diagnosis. Doctors today carefully examine the child’s body, so sometimes they prescribe tests that may seem unnecessary to parents in this situation. However, you need to undergo a full examination.

Tests and examinations for diagnosing appendicitis in children:

First of all, any the doctor examines and palpates the abdomen of a small patient . After identifying the first signs, tests are prescribed.
If the baby’s body is infected, a large number of white cells will predominate in the blood.
Urine microscopy . This test is taken to examine the presence of bacteria, red and white bodies in the baby’s body. In this case, the urine is carefully examined under a microscope.
Ultrasound . Without this examination, the diagnosis will not be accurate. Thanks to an ultrasound machine, the doctor can immediately identify what form of appendicitis the patient has.
They often do X-ray of the abdominal cavity. Using this study, you can determine the cause of appendicitis and identify adverse reactions that arose due to inflammation.
CT (computed tomography) . This examination is performed when there are signs of other concomitant diseases in the pelvic and abdominal area.
Laparoscopy . This type of diagnosis is the most accurate, but painful, so it is rarely used for children under 7 years of age. A thin tube with a camera pierced through the abdomen can clearly show the condition of the appendix and other organs.

Sometimes appendicitis is quite difficult to diagnose, so it is worth undergoing a comprehensive examination.

What should not be done before the doctor arrives if appendicitis is suspected in a child?

Some parents, not knowing the true cause of abdominal pain, try to help their child without consulting a doctor. This is fundamentally wrong. Anything related to abdominal pain should not be treated at home, because it can harm the baby even more with any pharmaceutical drugs.

To avoid complications of appendicitis, never give your child:

Painkillers.
Laxatives.
Drink a lot.

If you see symptoms of appendicitis in your baby, then immediately call an ambulance. It is better not to do anything at all until the doctors arrive.

Treatment methods for appendicitis in children: when is surgical and conservative treatment used?

Surgery is considered the most basic method of treating appendicitis. That is, the appendix is permanently removed through abdominal surgery or laparoscopy. The type of surgery depends on the degree of inflammation of the appendix.

Laparoscopy– a more gentle method of getting rid of appendicitis. After such an intervention, the recovery process is faster and more intense. The surgeon makes a small incision and, using a video camera and other instruments, removes the inflamed appendix.
In severe forms of appendicitis, it is carried out abdominal surgery . If the appendix has ruptured, open surgery is performed and the appendix is removed, clearing the abdominal cavity of pus and mucus.

It was previously believed that if there were no obvious signs of peritonitis, then appendicitis could be cured with infusions and antibiotics. But today this method of treatment is almost never found, since complications after appendicitis force doctors to use the latest technologies to relieve this inflammation.

Complications (abdominal abscess) may occur in the postoperative period. Therefore, after such an operation, children are obviously prescribed antibiotic therapy, which in 90% of cases eliminates the consequences of surgical intervention.

Causes and prevention of appendicitis in children

Today, medicine cannot say for sure why appendicitis becomes inflamed and who is at risk, despite the fact that medicine is rapidly developing. However, everyone agrees that you need to eat right in order to exclude the possibility of blockage of blood vessels or intoxication in the intestines.

Since it is unknown why one child has an inflamed appendix and another does not, doctors advise preventing this process. Doctors are sure of only one thing: in order for an appendix to appear, bacteria and a blockage of the cecum are needed. If these two indicators are present, inflammation of the appendix is inevitable.

Only those children whose parents experienced inflammation of the appendix (heredity) can be considered at risk. This fact has not been confirmed, but when treating appendicitis in children, many parents also talk about having their appendix removed.

With viral or infectious diseases, a decrease in immunity occurs, which leads to such consequences. The infection can penetrate the abdominal cavity, as well as the appendix itself, causing inflammation.

Prevention of appendicitis

In order to prevent appendicitis as much as possible, you need to exercise disease prevention (especially pay attention to infectious diseases), Healthy food (exclude fatty foods and a lot of sweets, include healthy foods in the diet: milk, cereals, light meat), etc.

It is impossible to protect your child from appendicitis 100%, but you can use every effort to minimize the risk of inflammation of the appendix by providing your child with a healthy lifestyle.