The most common symptom of appendicitis is pain in the right lower abdominal quadrant due to the anatomical localization. Additional symptoms are frequently nausea, vomiting, low fever and diarrhea or constipation according to case.

Appendicitis is commonly encountered in about 15% of the population and occurs mostly in the first two and last two decades of life. Every year, about 80000 Americans are diagnosed with appendicitis and about 50% of the children will have a medical history of appendicitis in their family. The appendix perforation occupies 30% of the cases and is mostly seen in children under the age of five.

A high percent of the cases of appendicitis are classical and can be diagnosed easily by history and a physical exam. Symptoms like pains in the right iliac fossa, vomiting, low fever, tenderness and rigidity of the abdominal area are usually certainty signs for an acute appendicitis. In case of more vague and unclear symptoms, the additional investigations like ultrasonography and computer tomography can be useful to establish a positive diagnose. No way of diagnose has an accuracy of 100% and in some cases the only option to make sure of appendicitis is present is surgical intervention.

The only possible cure of appendicitis is the removal of the infected appendix by surgical means; in case of perforation, the surgical intervention can only be performed after a few days of ant biotherapy to treat the clinical signs of inflammation spread to the whole abdomen and called peritonitis.

At the beginning of the operation, an anesthesiologist administrates the child a dose of sedatives and pain killers to induce the pediatric patient a pharmaceutical sleep. In classical interventions, a small incision is made in the right iliac fossa; if the surgical therapy is laparoscopic one, two smaller incisions are performed in different areas of the abdomen. Both methods have advantages and risks and the parents or caretakers must discuss and choose the most appropriate way with the surgeon.

The surgical intervention usually lasts less than one hour while the infected appendix is removed from the abdominal cavity and the infection fluids are washed out. In cases with further complications a drain is left inside the abdomen to continue draining the infection fluid out of the abdomen. After surgery, the child must stay in the hospital for about1-2 days in simple cases and 5-7 days in cases of perforation; painkillers and antibiotics are administered for avoiding complications. Oral food can be regained step by step in the first days after surgery.

Children will require a week at home to recuperate from surgery and about 2-3 weeks without sport activities. If complications like fever, excessive swelling in the incision area, bleedings or intense pains occurs, you must immediately call a doctor.