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The appendix sits in the lower right side of the abdomen (stomach). It is quite small and is a normal part of the bowel, but it is not thought to have an important role in the body.
Appendicitis is an inflammation of the appendix. Inflammation is most commonly caused by a small, hard piece of faeces (poo) getting stuck in the tube of the appendix. If the appendix is inflamed it is usually necessary to remove it with an operation called an appendicectomy (uh-pen-deh-sect-a-me).
Anyone can get appendicitis, but it tends to occur in older children and teenagers. It is rare for someone under the age of five years to get appendicitis. As a common condition, it can occur in multiple family members by chance - it is not a genetic condition.
There are many variations of the symptoms of appendicitis. Symptoms may include:
If you think your child has appendicitis, take them to your GP or local emergency department. A diagnosis of appendicitis is important because the inflammation causes the appendix to swell, and sometimes it can leak its contents into the stomach. This can make your child very sick.
If your child is in significant pain, which is made worse by moving or touching the stomach, go straight to your local emergency department.
The doctor will ask for a history of your child's symptoms and illness. They will examine your child by checking the site of the pain and pressing on the abdomen.
Sometimes it can be difficult to work out the cause of stomach pain as there are many possible reasons. If the doctor is not sure if it is appendicitis, they may keep your child in hospital and watch them to see if their symptoms get worse. Sometimes tests will be performed to help work out
what is going on, but these tests are not always helpful or reliable.
Your child may need an ultrasound or X-ray to take pictures of their abdomen. The doctor may also do a blood test to look for signs of infection or inflammation. In cases where children are sick and it is not clear why, your doctor may recommend an
operation to check the appendix even if they are not certain it is inflamed.
Most cases of appendicitis need an operation called appendicectomy. The appendix is normally removed through a keyhole operation with three, small keyhole cuts about 1-2cm long each, made in different parts of your child's abdomen. Rarely an open operation will need to be performed through a larger incision.
When a diagnosis of appendicitis is made, your child will be given antibiotics. Antibiotics will stop your child's appendicitis getting worse while they wait for their operation.
A surgeon, an anaesthetist (a doctor who puts your child to sleep during the operation) and nurses will explain all the procedures to you before they begin. If you have any questions or anything is unclear, ask staff to explain as many times as needed.
After the operation, your child can be given medicine directly into a vein through a drip (intravenous or IV therapy) to stop them feeling sick or vomiting.
Your child may need to have pain medicine, and some will be given antibiotics through the drip to prevent infection of the wound.
The time your child will be in hospital for depends on what is found during the operation. Some children can go home the day after surgery, most after a couple of days and a few will need to be in hospital for five or more days.
After the operation, your child will be given fluids through their IV drip until they can eat and drink again. This may be four to six hours after the operation.
Doctors will tell you when and what your child can eat and drink. It is very important to follow staff instructions. The bowel may need to be empty of food or fluid so it can rest after the operation.
When your child comes home from hospital, they should:
After you leave the hospital, a follow-up appointment will be made for your child to come back and see the surgeon.
There is a small risk of developing an infection or a bowel blockage after having a burst appendix. Contact your GP or take your child to the local emergency department if:
How can I tell if my child has appendicitis or if it is just
It can sometimes be difficult to tell what it causing your
child's stomach pain, because many of the symptoms of gastro and appendicitis
overlap. Generally, the pain will only be in the right side of your child's
stomach if it is appendicitis, and any vomiting or diarrhoea will be mild.
If your child has bad pain or persisting symptoms, see
What is mesenteric adenitis?
Mesenteric adenitis occurs when the lymph nodes in the
abdomen enlarge in response to an infection – most commonly a viral infection.
This causes stomach pain. The symptoms of mesenteric adenitis are similar to
the symptoms of early appendicitis, but do not progress in the same way.
What are the risks of surgery to remove the appendix?
All operations have some risks associated with
them, such as the risk of bleeding or infection. Complications due to surgery on the appendix are uncommon. Talk to your surgeon and anaesthetist about any concerns you
Developed by The Royal Children's Hospital Surgery Department. We acknowledge the input of RCH consumers and carers.
Reviewed August 2020.
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