Don’t take your child’s abdominal pain lightly and beware of acute appendicitis

Don’t take your child’s abdominal pain lightly and beware of acute appendicitis


When it comes to appendicitis, everyone is familiar with it, but when it comes to children suffering from appendicitis, parents are always surprised – can children also suffer from acute appendicitis? In fact, appendicitis has no age distinction. Whether it is a newborn, a child or an adolescent, the structure of the abdominal organs is the same as that of adults. As long as there is an appendix, there is a possibility of appendicitis.

Appendicitis in children is more difficult to identify

Acute appendicitis in children is the first surgical disease that causes acute abdominal pain in children, accounting for approximately 25% of the total number of acute abdominal pain cases in pediatric surgery. Acute appendicitis occurs from newborn babies to teenagers, and its incidence gradually increases as the age of the child increases. School-age children aged 6 to 10 are the most common, and the incidence is significantly reduced in children under 5 years old, especially those under 3 years old. Appendicitis in children under 1 year of age is rare. Appendicitis in children is prone to appendiceal perforation, appendiceal necrosis, and diffuse peritonitis. If the diagnosis and treatment are not timely, it will cause serious complications and even death, so parents must pay attention to it.

Why do children get appendicitis? At present, it is believed that the main reasons are as follows: obstruction of the appendix lumen, which is narrow and elongated, and the distal end is closed to form a head. Blockage of the lumen is the basis for inducing acute appendicitis; bacterial infection, Escherichia coli, Enterococcus Bacteria such as these invade the appendix lumen and induce appendiceal inflammation; gastric and intestinal dysfunction due to various reasons can reflexively cause spasmodic contraction of the appendiceal circular muscle and appendiceal artery, leading to appendiceal lumen obstruction or blood circulation disorder, causing appendix Acute inflammation.

Many times, doctors will find “bezoars” the size of peanuts in the removed appendix. These are stones formed by long-term accumulation of food residues. Some people think this is one of the causes of appendicitis. Some parents believe that running, jumping or strenuous exercise after meals will cause food residues to fall into the appendix, so they limit their children’s exercise after meals. At present, this view does not have sufficient scientific basis. Parents do not need to restrict their children’s exercise because of fear of appendix inflammation. Of course, it is not recommended that children engage in strenuous exercise immediately after eating. It is more beneficial to exercise 1-2 hours after a meal. Good for health.

What are the symptoms of appendiceal inflammation? Symptoms of appendicitis in children mainly include abdominal pain, fever, vomiting, decreased diet, etc. Among them, abdominal pain is the most common and earliest symptom. It usually starts around the umbilicus and moves to the right lower abdomen a few hours later. Fever may appear, but the fever may not be high. During physical examination, the child may find tenderness, rebound tenderness, and abdominal muscle tension in the right lower abdomen. If your child has the above symptoms, you need to be alert to the occurrence of acute appendicitis. Appendicitis in children is more difficult to differentially diagnose than in adults. The younger the child, the more atypical the clinical manifestations. In addition, factors such as infants and young children’s limited expression ability and lack of cooperation in physical examination will increase the difficulty of diagnosis. Therefore, if a child has acute abdominal pain, it is recommended to go to a children’s specialist hospital in time to strive for an early diagnosis and early treatment.

Prevention focuses on eating habits

My child has appendicitis, what should I do? In principle, if the onset of appendicitis occurs within 72 hours, regardless of the type of appendicitis, and if there are no clear contraindications, appendectomy should be performed. For children with severe appendiceal abscess formation or onset lasting more than 72 hours, antibiotic treatment can be given. During conservative treatment of appendiceal abscess, if the abscess continues to increase or the absorption effect is poor, puncture and drainage can be performed under ultrasound guidance to drain the pus, thereby accelerating recovery and reducing the time of antibiotic use. For appendicitis that has lost the opportunity for surgery, surgical treatment can be performed 2 to 3 months after conservative treatment. With the development of laparoscopic minimally invasive surgery, clinical laparoscopic appendectomy has become more mature in the treatment of acute appendicitis in children. Early detection, early diagnosis, and early treatment not only have less trauma, but also have a faster recovery period.

How to prevent appendicitis in children? The key is to maintain healthy living and eating habits in your children. The season with the highest incidence of acute appendicitis is summer, which is partly related to eating cold and raw food in summer and not paying attention to food hygiene. Parents should pay attention to allowing their children to eat regularly to ensure balanced nutrition, encourage children to exercise frequently and strengthen their physical fitness, so that children can feel happy and maintain a good attitude. . If your child develops diarrhea, constipation, gastrointestinal disorders, etc., seek medical attention promptly.

It is worth noting that acute appendicitis generally progresses quickly, and perforation may occur within 12 hours of onset. The degree of abdominal pain varies from person to person. Some obese children may not have obvious pain, but most children have typical right lower quadrant tenderness. If there is no clear tender point, consider the possibility of intestinal spasm, and you can use Kaiselu to relieve bowel movements. The abdominal pain can generally be relieved after defecation and exhaustion.

Of course, there are many causes of abdominal pain in children, and common ones include acute intussusception, volvulus, incarcerated hernia, congenital intestinal malrotation, intra-abdominal hernia, adhesive intestinal obstruction, etc. All in all, if a child has abdominal pain, finding out the cause is the key. Parents should know more about popular science to better protect the healthy growth of their children.

[The author is an attending physician at the General (Neonatal) Surgery Department of the Children’s Hospital Affiliated to the Capital Institute of Pediatrics]



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