Appendicitis may require surgical removal of appendix

Removal of the appendix (appendectomy) is one of the most common childhood emergency surgeries and tends to happen more in children ages eight to 16. The appendix is a small pouch shaped like a finger that branches off the large intestine. Although doctors are not sure what its purpose is, the appendix can sometimes become inflamed, blocked and swollen (appendicitis) with mucus or hard stool, or due to parasites or even a virus. When the appendix swells and if the infection goes untreated, the appendix can rupture (burst), which allows everything in the appendix to flow into the abdominal cavity. This spreads the infection and can lead to life-threatening peritonitis. An infection in the body that goes undiagnosed can be very difficult to treat later on so it’s important to be aware of the potential dangers of this condition.

How to know if child needs appendix removed

A child may have symptoms such as abdominal pain that starts in the middle of the belly, near the belly button, and moves down to the lower right side of the abdomen. This pain may feel worse with walking, jumping or coughing. Other symptoms of appendicitis in children include:

  • Changes in usual behavior
  • Diarrhea
  • Fever
  • Loss of appetite
  • Nausea and vomiting

Pediatric appendectomy is often an emergency procedure as the signs and symptoms may not be recognized right away. Be sure to call your doctor or go to the closest emergency room if you have any concerns about your child’s safety and well-being.

Preparing for pediatric appendectomy

Your child may undergo certain tests before surgery such as an ultrasound or CT scan, and may also need blood testing and urine testing done to determine how much infection there is. Your child’s doctor will also do an abdominal examination, which may sometimes be sufficient for diagnosis of appendicitis.

Appendectomy is a hospital procedure and requires general anesthesia, meaning your child will be asleep and will not feel anything. Before the surgery, your child will be asked to not eat or drink anything as this may interfere with the anesthesia. Depending on your child’s condition, the surgeon may choose to perform open surgery or laparoscopic surgery. Most pediatric appendectomies can be performed with minimally invasive laparoscopic surgery, which requires a small incision (cut) and a tiny camera inserted into the abdomen to guide the procedure. A child may need open surgery if the infection is severe. Open surgery requires an incision in the lower right of the abdomen and use of a drainage tube to remove fluids sufficiently for surgery to take place.

After surgery the child will not be allowed to eat or drink. This allows the intestine to heal. He or she will be “fed” fluids as well as antibiotics and other medications through an intravenous (IV) line until healing has taken place. Little by little your child will be given clear liquids such as Gatorade or apple juice and eventually solid foods.

Recovery from pediatric appendectomy

In order to be discharged from the hospital, your child must be able to walk, eat and drink without vomiting, must have no fever and have minimal pain. The doctor may recommend no heavy lifting or contacts ports for several weeks after surgery. Antibiotics and other pain medications may be needed for the first few weeks.

If you see any signs of infection, such as:

  • Drainage from the incision area
  • Fever over 101.5˚F
  • Redness or swelling
  • Swollen belly
  • Vomiting

Call your child’s doctor right away.

To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.