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Childhood Appendicitis

About 75,000 children are diagnosed with appendicitis every year in the United States. When children require emergency abdominal surgery it is most commonly appendicitis which is causing the problem. Appendicitis can occur at any age but is most likely to occur during the teenage years.

A delayed or missed diagnosis of appendicitis in children is too common, and when the diagnosis is delayed or missed, perforation of appendicitis often occurs.

Acute abdominal pain accounts for approximately 10% of childhood visits to primary care physicians or emergency rooms and about 10% of those children will require surgery. There is no doubt that most cases of abdominal pain in children who are taken to the emergency room are not the result of a serious condition such as appendicitis. However, doctors must consider that the abdominal pain seen in children in the emergency room may be due to acute appendicitis.

A common presentation for early appendicitis is pain around the belly button. In early appendicitis, distention of the appendix causes pain to travel to the belly button area. All the time the pain will move to the right lower aspect of the abdomen as the inflamed appendix causes irritation of the peritoneal cavity where the abdomen sits.

Acute appendicitis in children is the most common reason for urgent surgery. Without immediate surgery, appendicitis may progress to perforation of the appendix. In other words, the risk of perforation increases as time elapses from the onset of disease to treatment. An appendectomy delayed for more than 12 hours is associated with a significant increase in the rate of perforations, and resultant abscesses and peritonitis, thus appendectomy should be performed urgently, irrespective of the time of day.

Ultrasound is a non-invasive test that is inexpensive and does not expose the child to radiation. Doctors describe ultrasound as “1st line imaging“ in cases of suspected appendicitis.

A timely diagnosis and urgent surgery most likely lead to an uncomplicated appendectomy before the appendix ruptures. To learn more about delayed or missed diagnoses contact our team at (800) 817-5029.

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