How to identify chronic or acute appendicitis in children. Acute appendicitis: how to recognize the first symptoms in children and what not to do with inflammation

Article last updated: 04/20/2018

When most adults have a stomach ache, they simply relieve the pain with pills and get on with their day. If she's really strong, then maybe they'll stay at home. For the most part, we adults can tell if something is serious or not. If we think that it hurts more than usual, we turn to doctors for help.

When it comes to children, it's a completely different story. Children often have stomachaches. This can be due to a variety of reasons - not eating enough, too much or just the wrong food. It's almost impossible to tell if your baby's stomach ache is for a serious reason or if it's something minor.

Pediatrician, gastroenterologist

One possible cause of abdominal pain in a child is appendicitis. This is a serious problem that requires urgent treatment.

Appendicitis is an inflammation of a part of the intestine called the appendix. It is a narrow finger-shaped pouch located at the junction of the small and large intestines.

The reasons

If blood flow is reduced, the appendix begins to die. When a tear (perforation) appears in the walls of the appendix, it allows feces, mucus, and other substances to enter the abdominal cavity. This provokes the development of peritonitis - an infectious inflammation of the peritoneum, which is a formidable complication.

As a rule, acute appendicitis in children occurs between 8 and 16 years of age. But babies under 5 can also experience this condition, which often has more serious consequences, as they are unable to clearly communicate their symptoms.

How to recognize appendicitis in a child?

Although many children have the same symptoms of appendicitis as adults, it is often more difficult for doctors to diagnose appendicitis in a child. Especially when patients are too small to accurately describe their feelings and formulate complaints.

In addition, the study showed that the symptoms of appendicitis in children may differ from the signs of the disease in adults.

The main symptoms of appendicitis

Appendicitis has many symptoms, but there are some classic signs that many children and adults experience.

1. High temperature.

Adults with appendicitis may have a slight increase in body temperature. Children with appendicitis have a higher and more pronounced fever.

Studies have shown that in children from 2 to 5 years old, with the development of appendicitis, the stomach most often hurts and vomiting occurs. Fever and loss of appetite are also common.

2. Shchetkin-Blumberg symptom.

A symptom that is very specific to children. It is checked by pressing on the stomach in the projection of the appendix - in the area below the navel on the right. If you press the fingers of the hand, and then abruptly release, the pain intensifies. This indicates inflammation of the sheets of the peritoneum. The symptom in this case is considered positive.

In addition to the childhood symptoms listed above, any or all of the following common signs of appendicitis in children may be present.

3. Loss of appetite.

One of the signs of appendicitis in a child is a lack of appetite.

If your child refuses food and this is uncharacteristic for him, you should definitely pay attention to this.

4. Nausea and vomiting.

Nausea and/or vomiting are also typical symptoms of appendicitis.

Most often, nausea and vomiting occur in children after the onset of abdominal pain.

One of the signs of appendicitis is a dull pain in the navel or upper abdomen that becomes sharp as it moves to the lower right abdomen. Usually this is the first sign. In about half of the cases, other symptoms of appendicitis appear, including dull or sharp pain in the upper or lower abdomen, back, or rectum.

6. Inability to get rid of accumulated intestinal gas.

Since appendicitis is usually caused by an obstruction in the bowel, many children with appendicitis cannot pass gas, which creates additional discomfort.

7. An increase in the size of the abdomen.

Appendicitis develops when the appendix of the intestine swells and becomes inflamed, so it is often found that the abdomen becomes larger in children.

Although an enlarged abdomen can be a symptom of many diseases, it is a sure sign of appendicitis when combined with the other symptoms previously mentioned.

8. Constipation or diarrhea.

Although they are not as common as other symptoms, they are present in about half of the cases.

In addition In addition to the above symptoms, there are other, less common signs:

• severe spasms;
• painful urination and difficulty passing urine;
• bloody vomit or stools;
• inability to straighten up;
• pain that worsens during sudden movement (coughing, sneezing);
• bloating;
• green liquid vomit. It may be bile, which indicates obstruction of the stomach or intestines;
• the child complains of severe pain in the abdomen, lying on his side with his legs pulled to his stomach;
• the child complains of abdominal pain when walking.

Appendicitis is the most common reason for abdominal emergency surgery. Approximately 5% of people develop appendicitis during their lifetime. The peak age for the onset of appendicitis is between 10 and 30 years of age.

The overall number of cases of appendicitis is decreasing. Experts say this is due to the fact that people eat more fiber, which helps prevent blockage and the development of intestinal obstruction.

Risk factors

Heredity matters, and men are more susceptible than women. If a child has cystic fibrosis (an inherited disease that causes digestive and respiratory problems), they are also more likely to develop appendicitis.

Since children often develop abdominal pain, this is not necessarily a sign of something serious.

Usually, the abdominal pain a child experiences is the result of a non-life-threatening condition such as constipation, excess gas, streptococcal infection, large amounts of air swallowed, anxiety, or a mild food allergy.

Appendicitis can be difficult to diagnose due to its various symptoms, so it's important to call the doctor if you notice your child has had stomach pain for more than a day or more than one of the above symptoms.

Again, when you're not sure, call your doctor - it's much better to catch appendicitis early.

Survey

Diagnosing appendicitis can be challenging. The symptoms are often vague or very similar to other illnesses, including gallbladder problems, bladder or urinary tract infections, gastritis, Crohn's disease, intestinal infections, and ovarian problems.

The following tests are commonly used to make a diagnosis.

1. Abdominal examination (examination, palpation, percussion, auscultation) to detect inflammation.
2. Urinalysis to rule out urinary tract infection
3. Rectal examination
4. Blood test to detect infection
5. Computed tomography and/or ultrasound

The specific treatment for appendicitis is determined by the child's doctor based on the following criteria:

Because of the likelihood of the appendix rupturing and developing a severe, life-threatening infection, experts recommend surgery to remove the appendix.

The appendix can be removed in two ways.

public method

During anesthesia, an incision is made in the lower right abdomen. The surgeon finds the appendix and removes it. When the appendix is ​​torn, a small drainage tube may be placed to allow pus and other fluids in the abdomen to drain out. The tube will be removed after a while, when the surgeon sees that the infection has subsided.

Laparoscopic method

In this procedure, several small incisions are made and a camera (laparoscope) is used to view the inside of the abdomen during the operation. Under anesthesia, the laparoscope and the instruments the surgeon uses to remove the appendix are placed through several small incisions. This method is usually not used if the appendix has ruptured.

After the operation, the child is forbidden to eat or drink anything for a certain period of time. Fluids are introduced into the bloodstream through small plastic tubes until the child is allowed to drink fluids.

A child whose appendix has ruptured will have to stay longer in the hospital. Some children will need to take antibiotics after returning home for the period of time indicated by the doctor.

At the time of discharge from the hospital, the doctor will usually recommend that the child does not engage in weightlifting, do not participate in sports for several weeks after the operation. If the drain tube is still in place when the child goes home, then the child should not take a bath until the tube is removed.

Inflammation of the appendix of the caecum is called appendicitis. This disease is considered the most common in gastrointestinal surgery.

The pathological process covers not only adults, but also children. In babies, the temperature rises, a pain syndrome appears in the abdomen, vomiting opens, and the stool is disturbed.

This disease can only be cured by surgery. When the first attacks of appendicitis appear, you should immediately call a doctor.

To do this, you should learn to recognize appendicitis, the symptoms in children and why this disease occurs.

Disease danger

The main danger of childhood appendicitis is the rapid development of the acute form. It can lead to serious complications that threaten the life of a small patient.

Necrosis of the intestine and caecum may occur, and the inflammatory process may spread to adjacent sections of the gastrointestinal tract.

With the spread of inflammation in the abdominal cavity, peritonitis can occur, which is extremely difficult to treat.

The second major problem is the difficulty in diagnosing. For this reason, the pathology is detected late, which leads to the lack of timely treatment.

Appendicitis in children, by its signs, can manifest itself as intoxication, in which it is difficult for parents to discern the symptoms of inflammation of the appendix.

It is very important to understand the causes of the disease and the specific symptoms in order to seek medical help in time.

The reasons

Doctors have not fully figured out the functional component of appendicitis. Previously, it was believed that this organ is useless and it was proposed to remove it before the onset of the inflammatory process.

But this theory did not take root, since a theory appeared about the importance of the organ in maintaining immunity in the body.

The main reasons for the development of the pathological process are:

• Narrowing of the lumen of the appendix;
• Blockage of the lumen of the appendix with fecal stones, a foreign body.

With the development of these processes in the affected organ, pathogenic bacteria begin to actively develop.

Appendicitis in a child aged 2 years is quite rare. This is due to the fact that at this age he eats exclusively natural and sparing nutrition.

The appendix at this age is short, and the lumen is wide. As it grows older, it stretches, the lumen decreases, which leads to the complexity of cleansing the organ.

Risk factors

There are certain factors that affect the development of appendicitis in a child. All of them directly affect the development of the inflammatory process in the caecum:

An attack of appendicitis in a child is prone to very rapid development. This leads to disastrous consequences for the entire body of the baby in the shortest possible time.

For these reasons, the pathological process often extends to the abdominal cavity, which leads to serious and dangerous complications in the form of appendicular peritonitis.

A simple catarrhal form of the disease quickly flows into a destructive one. It is represented by phlegmous or gangrenous appendicitis.

Lack of timely treatment or ignoring the symptoms threatens the following serious consequences:

• Perforation of the walls of the affected organ, the development of peritonitis may occur;
• Development into a chronic form of the disease;
• The formation of intestinal obstruction;
• Blood poisoning leading to death;
• development of an appendicular abscess.

The time of development of peritonitis from the onset of the inflammatory process is on average 24-36 hours.

Chronic appendicitis in children is less common than in adults. It is characterized by periodic pain effects in the lower abdomen on the right.

These signs are joined by classic symptoms - nausea, an increase in body temperature is noted.

Symptoms

At the initial stage, signs of appendicitis in children can manifest themselves in different ways. The nature of the attacks depends on the location of the appendix.

The most obvious and first symptom is the appearance of pain in the umbilical region.

As the inflammatory process proceeds, the pain gradually shifts to the area where the appendix is ​​located.

The nature of the pain, depending on the location of the process:

• Classic location. The pain syndrome is shifted to the lower region of the peritoneum on the right.
• Pelvic location. There is severe pain in the area above the pubis, accompanied by frequent urination, diarrhea with mucus impurities.
• Subhepatic location. There are strong pain sensations under the right rib.
• retrocyclic arrangement. There are pain sensations in the lumbar region.

For any area of ​​localization of the appendix, small patients refuse to eat.

Signs of intoxication

In any form, the signs of appendicitis in children are very similar to poisoning. Small patients feel nausea, gagging, vomiting opens.

A distinctive feature of this disease from intoxication is the lack of relief after vomiting. In young children, vomiting opens once.

At school age, it can be single, or take place in two stages.

Temperature

An increase in body temperature is one of the main symptoms of the disease. How it manifests itself:

• In babies, the body temperature rises to critical levels - 40 ° C.
• In children aged 3-5 years, the thermometer indicator fixes 38-39 ° C.
• In schoolchildren and high school students, a rise in body temperature up to 38 ° C is noted.

Chair

One of the important signs of the disease is a violation of the stool:

• Young children have loose stools (diarrhea).
• At the age of 3-5 years, stool retention is observed in children, which should not be confused with constipation.
• In adolescence, as in adults, there are manifestations of constipation.

Language

When examining a patient, regardless of age, the surgeon always pays attention to examining the tongue. According to his condition, the doctor is able to determine the developing stage of the disease.

How is it shown:

• Simple or catarrhal appendicitis. The specialist notes the wet surface of the tongue, which is covered with a white coating at the root.
• destructive stage. Often, at the phlegmonous stage, the surface of the tongue is wet, completely covered with a white coating.
• gangrenous stage. It is the most dangerous, the surface of the tongue is dry, completely white.

You should be careful about this sign, especially in babies.

Symptoms by age

At each age, the symptoms of appendicitis can manifest themselves in their own way. It is very important for parents to learn to recognize the disease by the first signs.

Up to 3 years

At the age of three, the pathological process manifests itself instantly, its development proceeds very quickly.

The appearance of the first such symptoms should be a cause for concern and prompt medical attention.

Diagnosis is best done when the child is sleeping.

The most alarming symptoms characteristic of pathology are:

• Loss of appetite, refusal even from your favorite food;
• Decreased physical activity;
• Capriciousness, tearfulness;
• restless state;
• Sleep disturbances, insomnia on the first night of an attack;
• Nausea, vomiting;
• Raising the temperature to 40 ° C, and with breastfeeding up to 37.5 ° C;
• Frequent stools or diarrhea;
• Pain when urinating;
• Rapid pulse;
• The baby cannot be examined, he bends his right leg under him, squatting;
• When bending to the right or when moving, the pain syndrome intensifies. Sensations of severe pain when lying on the right side;
• Mucus-laden diarrhea, especially in diarrheal appendicitis.

The danger of the disease lies not only in the transition of a simple stage to a destructive one. With frequent diarrhea, the child is threatened with dehydration.

In what cases should you immediately call an ambulance:

• When raising body temperature, which has nothing to do with colds;
• For several hours, the child suffers from pain in the abdomen;
• Pain in the abdominal cavity worries when walking, aggravated by sneezing, coughing;
• Reducing pain when pressing on the affected area. With a sharp release of the hand, the pain intensifies.

3-5 years

Appendicitis in children 5 years old is easier to recognize. At this age, the child is able to show a painful place, complain about additional signs.

When diagnosing, this greatly simplifies the study, allows you to quickly make the correct diagnosis.

At this age, children can tolerate mild pain without complaining to their parents about the illness.

7 years

Symptoms of appendicitis in children 7 years old are similar to those of adults. But it is still quite difficult to make a diagnosis at this age.

The child can be very frightened, constantly cry, act up. Because of the fear of telling parents about their pain, children may hide the dangerous signs of the disease.

The most common symptoms in children 7 years old:

• Nausea;
• Vomit;
• Pain in the ruffle cavity;
• The chair is broken;
• Increase in body temperature;
• Deterioration of the general condition.

What symptoms in children of 7 years old should prompt parents to call a doctor:

• Decreased appetite;
• Nausea with single or repeated vomiting;
• high fever, chills;
• constipation or diarrhea;
• Dryness of the tongue, the surface of which is coated.

If the symptoms of appendicitis in children 7 years old appear separately or all together, they should be shown to the doctor no later than 2-3 hours after the onset of the attack.

10 years

In children 10 years old, the following symptoms of the disease are observed:

• The child is frightened, because of the fear of the operation, he can hide pain from his parents;
• Completely refuses to eat;
• feeling of weakness;
• There is pain in the entire abdominal cavity, passing after 2-3 hours to the right iliac region. When bending, the pain effect increases;
• Chills, fever up to 38°C;
• Dryness of the tongue, the appearance of a white coating on its surface;
• Single or double vomiting;
• Thirst;
• Constipation;
• Rapid pulse;
• Weak condition.

Adolescence

Signs of appendicitis in a teenager over 12 years of age are manifested in a discrepancy between the pulse rate and body temperature.

The pulse is noted to be rapid, and the body temperature is low. Only a specialist should be engaged in diagnosing the disease and checking this symptomatology.

Symptoms of appendicitis in adolescents aged 14-19 years are very similar to the symptoms of the disease in adult patients.

At this age, pathology occurs most often. If the signs of the disease appear in the girl, she must be given a referral to the gynecological department for examination by a gynecologist.

This measure is necessary to exclude pregnancy or diseases of the female genital organs.

When the first signs of the disease appear, parents should carefully look at their child.

All symptoms are studied in detail, a doctor is urgently called. In no case do not apply a heating pad to the affected area.

Heat will increase the inflammatory process, aggravate the course of the disease. Before the doctor arrives, it is forbidden to give painkillers on your own, as they can lubricate the symptoms of the disease.

With the diagnosis, it will be more difficult for the doctor to make a diagnosis. Also, you can not do enemas and give laxatives to combat constipation.

Diagnosis is carried out by a doctor by palpation. If a pathological process is suspected, testing is mandatory.

For this, the child is given an ultrasound scan, urine and blood tests. When the child is hospitalized, they are brought to a medical facility.

In the emergency room, a detailed examination of the patient is carried out, if the pathology is confirmed, the child is sent to the surgical department.

Treatment is exclusively surgical. After surgery, antibacterial drugs may be prescribed to exclude infection, rapid wound healing.

Particular attention is paid to the postoperative period. Be sure to appoint a special diet and bed rest.

Useful video

Appendicitis is the fourth most commonly misdiagnosed disease. Especially those who still cannot say exactly where it hurts. Therefore, every mother should know the symptoms of appendicitis in children, so as not to confuse it with and consult a doctor in time.

There is a misconception that acute appendicitis does not threaten young children - in fact, such a risk exists even in infants, albeit a small one. The frequency of inflammation of the appendix grows after 2-3 years. 18-20% of those with this disease are preschoolers. Parents of babies of this age should be especially wary, because appendicitis is very difficult to diagnose in them. A small child often cannot say exactly where it hurts, so doctors have to deal with peritonitis (due to a ruptured appendix).

Often appendicitis in children develops due to a decrease in immunity. A weakened body cannot resist the attack of viruses - the infection penetrates the appendix and causes inflammation. Various diseases (tonsillitis, SARS, otitis media, etc.) can also contribute to this.

The complexity of diagnosing acute appendicitis in babies lies also in the fact that its symptoms are common to many diseases. And not every child has them all.

The most accurate diagnostic method is computed tomography (CT). American scientists consider ultrasound diagnostics to be ineffective, especially when it comes to young children, since it makes frequent mistakes.

But it is still important that parents are able to recognize the danger on their own. If the child still cannot clearly talk about his feelings, you should be alerted that he curls up, lies on his side (usually on his right), tucking his knees to his stomach, knocks with his feet, expresses anxiety when changing positions, tries not to move, but his expression is pained, wary. If you try to feel the belly, the baby will not let you touch it.

Signs of appendicitis in children under 5 years of age

One of the symptoms of appendicitis in a child is vomiting, it can be single or multiple, but in any case it does not bring relief to the child. In young children (under 3 years of age), appendicitis can also be painful when urinating. Other symptoms of appendicitis in children:

• nausea, vomiting;
• anxiety, whims, drowsiness, weakness;
• pallor, dry mouth, thirst;
• fever, chills;
• sometimes loose stools or, conversely, constipation;
• inability to cough, jump, or walk over bumps, drive a car without pain;
• difficulty walking.

At the same time, some experts argue that the symptoms of appendicitis will not necessarily include a change in stool, vomiting or diarrhea.

If the child can tell you how they feel, then notice if they have a persistent, unexplained (lower right corner) that lasts more than 24 hours.

If the baby has several of the above signs, you should immediately consult a doctor.

Signs of appendicitis in children from 7 years

There are several ways to determine appendicitis in children over 7 years old, which parents can do before the doctor arrives:

• ask the child to cough loudly - if the pain in the right iliac region increases - this may be a symptom of appendicitis.
• a sign of appendicitis is also an increase in pain in the right iliac region when the child is turned to the left side from the back.
• if the child, lying on his right side, pulls his legs up to the body and the pain decreases, and then straightens his legs and turns to his left side, and the pain intensifies, this may be a sign of appendicitis.
• do not feel the abdomen with your fingers, it can be very dangerous for a child. To compare pain in the right and left iliac region, only light tapping with a fingertip is possible, if the child feels pain on the left side, but not on the right side, this can also be a symptom of appendicitis in a child.

Parents can do such self-diagnosis only in order to urgently call an ambulance if appendicitis is suspected.

How to distinguish appendicitis in a child from an intestinal infection

Both with an intestinal infection and with appendicitis, a child can have diarrhea and vomiting, so it is not uncommon that these symptoms are mistaken for signs of an intestinal infection. Our infographic will help you distinguish appendicitis from an intestinal infection.

Also note that the appendix may be located atypically, then the child will feel pain in other parts of the body. For example:

• retrocecal (behind the caecum)- the child feels pain in the lumbar region, radiating to the groin;
• with pelvic localization of the appendix- pain manifests itself in the lower abdomen and above the pubis;
• with subhepatic localization of the process- Pain in the liver.

Sometimes pain in children can have a rare localization - give to the back, perineum and genitals, ureter, stomach, which makes it difficult to diagnose the disease.

What not to do if you suspect appendicitis

• do not apply a heating pad to the child's stomach and do not do warming baths - heat accelerates the inflammatory process
• do not give the baby an enema, which increases pressure on the inflamed organ
• do not give him painkillers (may complicate the diagnosis) and laxatives (may provoke a rupture of the appendix)
• do not feed him, you can only give sweetened water

Remember: in the event of abdominal pain in a child, it is impossible to independently, without establishing the cause of its occurrence, begin treatment. Be sure to call your doctor! In case of any suspicion of appendicitis in a child, immediately seek medical help. Any delay can cause the appendicitis to turn into peritonitis, and the inflamed appendix can burst at any moment, with all its contents, along with pus, ending up in the child's abdominal cavity.

Appendicitis is an inflammation of the appendix. This is the part of the large intestine, which is located in the lower abdomen on the right. This is his default location. It can also be localized in the liver, in the pelvis, or mirrored in 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.

Most often, appendicitis develops in children from 9 years of age.

Causes of appendicitis in children

The causes of appendicitis in children is the overlap 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 reason 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 process.

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

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

The first signs in children and adolescents

Appendicitis develops abruptly and can catch a child anywhere.

The first symptoms of the disease are:

• pain - pain sensations first appear in the epigastric region. Then, as the disease progresses, they move lower. The final place of localization is the right side of the abdomen from below. At first, the pain is mild, insignificant. But due to the intensification of the inflammatory process, its intensity increases, and, in the end, it becomes unbearable;
• children are restless, crying, refusing to eat;
• when feeling the abdomen, there is a sharp pain. 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, the position on the right side is painful;
• fever is not a pathognomonic symptom for appendicitis. It may not be at all, or, conversely, a fever of up to 40 ° develops.

If you experience these symptoms, contact 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 is rare in children under 2 years of age.. This is due to the peculiarities of the nutrition 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 hardly overlaps.

But unfortunately, inflammation of the appendix can also occur in infants. In this case, the diagnosis of 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, the child cries in his arms.

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

The complexity of the course of the disease lies in the fact that a small patient cannot tell that his stomach hurts.

Symptoms of appendicitis in children 2-3 years old similar to those of breasts. But at the same time, a small patient of this age may respond to painful palpation of the abdomen. Appendicitis in such children proceeds rapidly and develops into peritonitis at lightning speed. Symptoms of inflammation of the appendix at an early age also include vomiting, diarrhea with mucus, fever. The pain intensifies on the first night of the disease, so the children do not sleep well, 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 show the stomach in the navel. Children become lethargic, refuse to eat and play, squatting causes pain. The forced position attracts attention: they lie on their left side, pulling their legs to their stomachs. This reduces muscle tension, and therefore pain. Vomiting, as well as diarrhea, may not be.

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

Little smarties can cheat. When they see a doctor, they can say that nothing hurts them, if only they were not taken to the hospital. Therefore, it is worth paying attention to the position of the child: it is difficult for him to unbend, he walks or lies crooked, cannot turn on his right side. It 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, he will point to it, while the child can already clearly determine the place of pain. With a typical location of the process, the pain is concentrated on the right lower abdomen. If the appendix is ​​under the liver, then pain occurs in the right hypochondrium.

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

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

The causes of inflammation in children 10-11 years old is a strong growth 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 disease progresses more slowly. For example, pain and other symptoms in appendicitis in adolescents 12-13 years old occur a few 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 is acute and chronic.

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

• appendicular colic- inflammation is small, fades after a few hours;
• catarrhal appendicitis- the usual acute inflammation of the appendix;
• phlegmonous- characterized by purulent inflammation, the appearance of ulcers. May break;
• gangrenous- develops as a result of thrombosis of the vessels of the appendix. There is its atrophy and decomposition. The child's condition is serious.

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

Symptoms of chronic appendicitis in children- these are periodic, not pronounced pains in the abdomen on the right after exercise or malnutrition. They pass quickly. Nausea, bloating, and upset stool also occur. Periods of remission may be replaced by relapses. Symptoms of the disease are the same as in acute appendicitis.

Diagnosis of appendicitis

In the recognition of the disease, it plays a leading role in the symptoms of the disease.

The appearance of severe, prolonged pain in the abdomen is a reason to see a doctor.

1. Inspection. There are several main symptoms that are a sign of appendicitis:
   • Shchetkin-Blumberg symptom- gently press on the area of ​​\u200b\u200bthe appendix on the abdominal wall and quickly tear off the hand. With a positive reaction, there is a sharp pain;
   • Rovsing's sign- press on the lower abdomen on the left. Without removing the hand, the second jerkily presses the abdominal wall a little higher. The pain at the same time gives to the right iliac region;
   • symptom of the Resurrection- run a hand over a tight shirt along the abdomen. Pain, again, appears in the abdomen on the right.
2. Rectal examination.
3. Blood analysis reveals an increase in leukocytes, or rather neutrophils. Erythrocytes, leukocytes, protein appear in the urine.
4. ultrasound abdomen and pelvis, CT.
5. Laparoscopy.
6. For adolescent girls, a gynecological examination is mandatory..

Do not attempt 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, laxatives are also contraindicated. Do not apply a heating pad with either hot or cold water.

Do not delay your visit to the doctor. If your child does develop acute appendicitis, then the only treatment is surgery.

The fastest and least traumatic method is laparoscopy.. The surgeon makes several punctures, and with the help of an endoscope and a camera, removes the process. After such an operation, children quickly recover, after a week they are already discharged, of course, subject to the regimen and diet.

In a complicated form, an open operation is used.. Before it, infusion and antibiotic therapy is carried out. After such an operation, the recovery period lasts a little longer.

Appendicitis can have complications. These include:

• peritonitis develops at a rupture of a shoot. The contents of the intestine spills into the abdominal cavity, causing further development of the infection. In children, there is an increase in body temperature, severe pain in the abdomen, intestinal gas. As the process intensifies, the pain disappears. There is a clouding of consciousness;
• appendicular abscesses, infiltrates, bleeding. Develop 5-7 days after surgery. Their manifestations are acute pain and hyperthermia;
• sepsis- the infection enters the blood, there is a generalized inflammation of the whole organism;
• suppuration of the postoperative wound. In this case, antibiotic therapy is prescribed, the sutures are removed, the wound is treated and drainage is placed;
• intestinal obstruction.

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

Appendicitis is a disease of childhood. With a timely appeal for help, it is easily eliminated and the child quickly recovers.

With a negligent attitude to its symptoms, inflammation of the appendix can have serious consequences, delaying treatment and for a long time removing the child from active life.

When a child has a stomach ache, many experienced mothers, even before the doctor arrives, begin to assume - indigestion, poisoning, eating new, unfamiliar foods. Diagnosis is complicated if the child is small and cannot show exactly where it hurts and cannot tell about the nature of the pain. In such cases, some mothers begin to suspect appendicitis with fear. Of course, only a doctor can confirm or refute the diagnosis, but parents should be able to distinguish between some of the primary signs of appendicitis and, if necessary, urgently take the child to the hospital. Today we will talk about the features of the course of appendicitis in children, the symptoms and causes of the disease, as well as the surgical treatment of inflammation.

Features of the course of appendicitis in children

Many mistakenly believe that appendicitis occurs only due to intestinal blockage when a person consumes seeds and nuts with husks. Moreover, there is a myth that children do not get appendicitis. But it's not. Of course, the appendix can become inflamed due to food debris getting into it, but this is far from the only reason. Appendicitis can become inflamed even in infants who have never tasted anything other than mother's milk.

Appendicitis is an inflammation of the appendix, a small appendix of the caecum. Inflammation can be caused by various reasons - we will talk about them a little later. Most often, appendicitis develops in adolescents - 13-19 years old. Less often, the appendix can become inflamed in children of primary school age. Appendicitis can also affect a baby, but this is extremely rare.

The peculiarity of the course of appendicitis in children is that the disease develops extremely quickly. Everyone knows that with appendicitis, you need to see a doctor as soon as possible. Surgery can save a person from peritonitis - there is simply no other effective treatment for appendicitis. In the case of children, you need to respond as quickly as possible. The fact is that some organs and parts of the peritoneum in children are not developed and are formed only by adolescence. We are talking about a large omentum, which is formed only during puberty of a teenager. He is able to protect and, as it were, fence off the inflamed area. Since the greater omentum is not yet developed in babies, appendicitis proceeds rapidly, until the last moment without making itself felt.

Among the features of the course of appendicitis in children is the localization of pain. In adults, "appendicitis" pain is located on the right side below the navel. Structural features of the child's body indicate that pain in appendicitis will be localized above the navel - in infants by 3-4 cm, in children under three years old - by 2 cm, in a child of 10 years old - by only 1 cm. As human organs grow , as well as the appendix, are displaced. So what symptoms in a child can tell about a possible appendicitis?

How to recognize appendicitis in a child

Here are some symptoms to watch out for parents.

1. The very first thing that will happen to a child is that he will feel worse. This may be accompanied by various symptoms - apathy, tearfulness, bad mood, refusal to eat, etc. From this moment on, the mother should monitor the baby more closely and pay attention to the accompanying manifestations and signs.
2. Appendicitis is necessarily accompanied by pain in the abdomen. The child may complain of spatial pain in the abdomen. Often children, especially small ones, do not indicate the exact localization of pain, they say that the stomach as a whole hurts. In some cases, pain can radiate to the sides, pelvis, and even the spine.
3. Finding out what and where the child hurts, try to calm the child and calm down yourself, often older children can lie and not complain about pain until the last, as they are afraid of surgery, hospitals, doctors, etc.
4. It is important to understand that inflammation can develop in a matter of hours and will make itself felt unexpectedly. The stomach can immediately start to hurt a lot at school or kindergarten, on the street, etc.
5. If the pain in the abdomen is minor, follow the child for a while. On the first night, the child may not sleep well, he constantly screams, cries, whimpers, moans.
6. Try to touch the child's stomach - if he pulls your hand, pulls away, screams sharply in pain, most likely it is appendicitis.
7. It is extremely difficult to diagnose inflammation in young children in the first months of life, since many of the symptoms can be similar to infantile colic. Unfortunately, in most cases, appendicitis in infants is diagnosed after peritonitis.
8. The baby should be monitored very carefully. With appendicitis, the baby cries constantly, regardless of the time of day. With colic, children usually act up and cry at the same time of day. The baby can tuck his legs under him, twists them, cries out when he touches his stomach, tries to lie on his left, painless side.
9. Very often, appendicitis at any age is accompanied by profuse vomiting and a feeling of nausea, diarrhea. With diarrhea, mucus may be present in the stool. Sometimes stool disorders can be caused not by diarrhea, but, on the contrary, by constipation.
10. The inflammation can be so extensive that the pain passes to the genitourinary system. Older children may complain of pain when urinating, young children simply cry in the process.
11. Like any inflammatory process, appendicitis is accompanied by an increase in body temperature. It can be either a prolonged subfebrile temperature, not exceeding 37.5 degrees, or very high, up to 40 degrees. But not in all cases, the temperature can be considered a fundamental symptom, sometimes appendicitis occurs without its increase.
12. A child with appendicitis may become pale, often accompanied by excessive thirst and dry mouth.
13. With mild pain, the child can squat while playing and press the right leg to the stomach in search of a comfortable, painless position.
14. Another way to identify appendicitis in a child is to feel his stomach. In a healthy baby, the abdomen should be soft. A hard and tense stomach indicates inflammation.
15. In the acute stage of appendicitis, the child will not be able to stand up straight and walk even a few steps - this will bring him severe pain on the right side of the abdomen.
16. Since diagnosing appendicitis in a child is always difficult, doctors use this method. The baby needs to be put on a flat surface, raise the right leg and bend it at the knee. If, at the same time, a sharp pain in the right side of the abdomen pierces the child, there is no doubt that this is appendicitis.

If you notice at least a few of the above symptoms in a child, you need to see a doctor as soon as possible to clarify the exact diagnosis.

Causes of appendicitis in children

The causes of inflammation of the appendix are in many ways similar to adult appendicitis, let's try to consider them in more detail.

1. In order for the appendix to become inflamed, two conditions must be met - the entry of a pathogenic infection into the rectal cavity and clogging of the process. The first can occur in case of poisoning, ingestion of microbes, bacteria.
2. Blockage of the process can occur for various reasons - from the banal features of the physiological structure of the appendix to blockage by foreign objects. The passage to the appendix can be closed by feces, the remnants of undigested food - the husks of seeds, nuts, etc.
3. The risk of developing appendicitis increases if the child's body is weakened and unable to resist the inflammatory process. Immunity can be reduced due to frequent illnesses, malnutrition, constant overheating of the child.
4. Appendicitis in children often occurs due to foreign objects entering the intestines. It happens that children eat berries with seeds, a fish bone or, in general, a small part from a toy can get into the body. This can cause blockage of the process.
5. Sometimes blockage of the process can occur against the background of active reproduction of helminths in its cavity.

In general, even doctors cannot say with accuracy what caused the inflammation of the appendix in this or that case. The above symptoms are very conditional and only increase the risk of developing appendicitis, although they cannot fully explain the problem.

If you notice some of the symptoms in your child, which we told you about above, you need to act immediately. It is better to play it safe and refute the diagnosis in the hospital than to hope for the best and wait for complications at home.

If you suspect a child has appendicitis, you need to get to the hospital as soon as possible, where there are operating surgeons. Consider whether it makes sense to call an ambulance or whether you can get to the hospital faster in your car. In no case should you give your child antipyretics, painkillers, laxatives or other drugs that can reduce the severity of the symptoms of the disease. This will make it difficult to make a correct diagnosis.

In addition, in no case should you give your child drugs for the intestines - some formulations can provoke a rupture of the inflamed appendix ahead of time. Also, try not to give anything to drink or feed the child, because you may need an urgent operation. Another prohibition - do not apply a hot compress to the sore side until you know the exact diagnosis. With appendicitis, heat will only increase the inflammatory process. One should beware of any warming procedures - hot enema, sitting in a bath with hot water, etc. But you can apply cold, this will narrow the blood vessels and reduce the manifestation of pain. Wrap a piece of ice or frozen meat in a bag and a towel, attach it to your stomach - where the pain is the most.

You need to put the child in a comfortable position that causes him less pain, and then take him to the doctor as soon as possible. If the doctor confirms the diagnosis of appendicitis, the baby will have surgery.

There is no need to be afraid of surgery. To date, the operation to remove the inflamed appendix is ​​considered one of the simplest and most common. A few decades ago, there were attempts at conservative treatment of appendicitis - inflammation was healed with antibiotics, etc. However, to date, such treatment is ineffective for several reasons. Firstly, after such exposure, sooner or later, the appendix still starts to hurt again - the inflammation resumes. The second reason is that the process can break at any time, this is a big risk. Another reason is that inflammation becomes chronic, it is expressed with fewer symptoms, but slowly affects neighboring organs - the rectum, peritoneum, etc. By removing the unnecessary process surgically, we solve this problem once and for all.

Complications of appendicitis are deadly. If the pain suddenly stops, this may indicate serious consequences, most likely, peritonitis has occurred - the intestine has ruptured and its contents have entered the abdominal cavity. To prevent this, you need to see a doctor as soon as possible.

How to protect your child from appendicitis

As noted, appendicitis in children can occur for various reasons. To protect your child from inflammation of the appendix, you need to follow a few rules of prevention.

1. Nutrition should be correct, balanced, according to the age of the child.
2. It is necessary to prevent the development of constipation, especially chronic. To do this, you need to eat more fiber, consume sour-milk products, limit the intake of simple carbohydrates, drink more clean water. After all, fecal stones, which are formed during long-term constipation, are most often the cause of blockage and inflammation of the appendix.
3. Monitor the health of the gastrointestinal tract - do not overeat, treat diseases of the stomach and intestines in time, regularly do fasting days, cleanse the intestines with laxative foods.
4. Watch the child so that he does not take foreign objects into his mouth. Keep all small parts of toys out of reach. Make sure that the child does not swallow fruit seeds and other objects that need to be spit out.

These rules do not guarantee you one hundred percent protection against appendicitis, but they are quite capable of reducing the risk of its development.

Appendicitis is a complex and mild disease at the same time. On the one hand, the surgical operation to remove appendicitis is quite simple, the postoperative period is short - the person recovers quickly. On the other hand, diagnosing appendicitis is quite difficult, especially if parents associate abdominal pain with food poisoning and do not take the child to the hospital until the last. Delay can cost the baby his life. Therefore, do not be shy and do not be lazy to once again seek medical help. Take care of the child, because he has no one else to rely on.

Video: symptoms of appendicitis in children