Pediatric appendicitis is an emergency requiring removal of the appendix

Appendicitis is a medical emergency. It is likely the appendix will burst and cause a serious, deadly infection. For this reason, your child’s healthcare provider will likely advise that your child has surgery to remove the appendix.

The appendix may be removed in two ways:

  • Open or traditional surgery – Your child is given anesthesia. A cut or incision is made in the lower right-hand side of the belly. The surgeon finds the appendix and removes it. If the appendix has burst, a small tube or shunt may be placed to drain out pus and other fluids from the belly. The shunt will be taken out in a few days when the surgeon feels the infection is gone.
  • Laparoscopic surgery – Your child is given anesthesia. This method uses a few small incisions and a camera called a laparoscope to look inside the belly. The surgical tools are placed through one or more small incisions. The laparoscope is put in through another incision. This method is not usually done if the appendix has already burst.

Interval appendectomy involves treating infection before performing surgery

Sometimes the appendix bursts and a collection of infected fluid or pus (abscess) may form. If this happens and your child is stable, the provider may recommend not removing the appendix right away. Instead, the provider may want to treat the infection first and drain the infected fluid from the abscess. The appendix will be removed later. This delayed surgery is called an interval appendectomy.

For an interval appendectomy, your child may first have IV antibiotics. These are given through an IV tube called a PICC line, or a peripherally inserted central catheter. This is done for about 10 to 14 days. Also, the provider may use CT or ultrasound-guided images to drain the abscess. Once the infection and inflammation are gone, your child will have surgery to remove the appendix about six to eight weeks later.

Complications that may arise from pediatric appendicitis

An irritated appendix can quickly turn into an infected and ruptured appendix. This can happen in a few hours. A ruptured appendix is an emergency situation. If not treated, it could be fatal. When the appendix ruptures, germs (bacteria) infect the organs inside the abdominal cavity. This causes a bacterial infection called peritonitis. The bacterial infection can spread very quickly. It may be hard to treat if the diagnosis is delayed.

If you think your child has appendicitis, call your child’s provider or go to the emergency room right away.

To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (1.866.225.5654) or use our secure online appointment request form.