Appendicitis is the inflammation of the intestinal diverticulum responsible for a very small part of the immune system function. The inflammatory process occurs when the organ lumen becomes obstructed with fecal, bacteria or foreign bodies. The blood flow to the appendix is interrupted and the organ begins to die causing irritation and infection due to the increased growth of bacteria.



Appendicitis is the most frequent surgical emergency in children of 5 years and up to 20. About 4 children in 1000 are annually operated from appendicitis in the USA and studies have proven that appendicitis is more common during the summer months. Theoretically, appendicitis can occur at any age and in cases of smaller children diagnose is far more difficult to establish. The first symptom of appendicitis in older children is usually loss of appetite followed by a diffuse abdominal pain that intensifies and localizes in the lower abdominal quadrant in a few hours.

Diagnose becomes more difficult when the appendix is localized in another anatomic part of the abdomen and the pains have an un-classical location. In such cases, an acute appendicitis can mime a bladder infection or an urinary tract infection with additional symptoms given by the particular localization. Other classical accompaniment symptoms of appendicitis are nausea, vomiting, diarrhea or constipation by case and low-grade fever and chills.

Children with appendicitis are usually observed as very still, avoiding movements and walking with limps to protect the moves of the right leg. Higher fever is usually associated with a perforation of the appendicitis into the abdominal cavity leading to peritonitis. This is the generalized infection of the abdomen and can have deadly consequences upon the vital organs located inside the abdomen.

A good examination for diagnose begins with the medical history of the child and evolves with a complete physical exam and additional investigations such as computer tomography and ultrasonography. Other major investigations that can reveal important diagnose data are blood analysis searching for an increased number of white blood cells, and a complete urine analysis.

The best treatment and in most cases the only treating option in appendicitis is the surgical removal of the inflamed appendix. Patients receive antibiotics before and after the operation to prevent infections. They must stay in the hospital for observation for about 24-48 hours and can return to their normal activities in about 5 days to one week. Patients who have been later diagnosed need more complex help and will be administered antibiotics a few days after the surgical intervention. The ones with appendix perforation require more days of hospitalization and about 5 days of ant biotherapy before surgery.