Appendicitis: Children and Teens

Appendicitis is an inflammation that can lead to infection of the appendix. It is the most common reason for a child to need emergency abdominal surgery. Young people between ages 10 and 30 are most often affected. A child may have a greater risk for appendicitis if someone else in the family had it. Boys are at higher risk.

The appendix is a small, fingerlike organ. It is attached to the large intestine in the lower right side of the abdomen. Appendicitis happens when the appendix is blocked by a piece of stool or a foreign object that was swallowed. It can also happen as a result of swelling from an infection. Bacteria then invade the wall of the appendix. This causes more damage.

If the infected appendix isn't removed, it may leak or burst. This can cause either an infection or a life-threatening condition called peritonitis.

There’s no way to prevent appendicitis. It is rare in countries where people eat a high-fiber diet, but experts haven't yet shown such a diet definitely prevents it.

Signs and symptoms

The symptoms of appendicitis in older children and teens are:

• Belly (abdominal) pain

• Fever

• Vomiting

The pain usually begins in the center of the abdomen, around the area of the navel. Later, it may move downward and to the right.

After belly pain begins, older children and teens usually develop the following symptoms:  

• Fever

• Loss of appetite

• Nausea

• Vomiting

Other symptoms may include:

• Diarrhea

• Need to urinate frequently

• Constipation

• Respiratory symptoms

In children younger than age 2, the most common symptoms are vomiting and a bloated and swollen abdomen.

Diagnosis

It can be difficult to diagnose appendicitis, especially in younger children. Even experienced healthcare providers aren’t able to diagnose it 100% of the time. A diagnosis is made with the following:

• Lab testing

• Ultrasound

• CT scans

• Health history and physical exam

Treatment

Appendicitis is a medical emergency that is most often treated with surgery. If the appendix is removed before it bursts, complications are rare. The hospital stay is usually 2 or 3 days. If the appendix bursts, a longer hospital stay is needed after it’s removed. 

In some cases, appendicitis may be treated with antibiotics alone. Or drainage is done through the skin and an appendectomy is done at a later time.  

When to call your healthcare provider

Call your healthcare provider right away if you think your child has appendicitis. This will give your healthcare provider more time to confirm the diagnosis. It will also allow time for the infected appendix to be removed before it leaks or bursts and spreads infection. If you are unable to contact your healthcare provider, don't wait. Go directly to the emergency room.

If your child appears to have appendicitis, don't give him or her any pain medicine or anything to eat or drink. Having an empty stomach speeds preparation for surgery, if needed.