When 37-year-old Prasad was diagnosed with appendicitis and underwent an emergency appendectomy, his family and work colleagues were concerned only when he would be able to return to work. A few months later, his 6-year-old son was also diagnosed with appendicitis. Everyone was surprised then. “Appendicitis in children? Never heard of such a thing. Must be a wrong diagnosis. You should get a second opinion,” they said.
What is appendicitis?
The appendix is a worm-like structure attached to the first part of the large intestine called the cecum and found in the lower right portion of the abdomen. Initially thought to be a useless structure, it is now known to help the immune system. Appendicitis occurs when mucus, stool, or a combination of the two blocks the opening of the appendix to the cecum. Bacteria multiply in the confined space and infect the lining of the appendix. If the inflammation and blockage is so severe, the tissue in the appendix can die and even rupture or rupture, leading to a medical emergency.
Why does a child get appendicitis?
Studies have reported that the incidence of appendicitis varies by diet, hygiene, socioeconomic status, ethnicity, seasonal changes, family history, age and gender. Inadequate dietary fiber intake and the resulting constipation are believed to be the cause of childhood appendicitis in 70% of cases.
Has the incidence of appendicitis in children increased in recent years?
Clearly good advances for society, such as better hygiene and better socioeconomic status, are paradoxically associated with increased incidence of appendicitis. It’s in this league. A study published in Canada in 2017 showed a rapid increase in the incidence of appendicitis in developing countries. More worrying data came out of a university hospital. In the same year, researchers concluded that in Leicester, England, there was a significant increase in the incidence of appendicitis in children under the age of 14.
How do you diagnose appendicitis in children?
A common complaint or symptom of appendicitis is the sudden onset of abdominal pain in the lower right quadrant, often accompanied by vomiting and fever. Surgeons elicit several clinical signs to diagnose appendicitis. The most common is “MC Barney point rebound soreness”. However, these symptoms and signs described are not always present in children, making diagnosis more difficult and delayed. purulent pus is formed.
Often other conditions in children mimic appendicitis such as pneumonia, severe intestinal infections or, rarely, ovarian conditions in girls. is. A good medical history and a detailed examination of the child almost always confirm the diagnosis, but confirmation by imaging in the form of an ultrasound scan or rarely a CT scan may be necessary.
Facts About Childhood Appendicitis
Pediatric appendicitis is on the rise and is seen in younger and younger children.
Rarely, newborns have also been reported to get appendicitis.
A general trend towards a diet low in fiber may be responsible for the increased incidence of appendicitis in children.
Symptoms of appendicitis may not be as classic as those seen in adults, which may delay diagnosis.
Childhood appendicitis more commonly progresses rapidly to advanced stages such as rupture.
Appendicitis can be treated with laparoscopy, as in adults at any stage.
How do pediatric surgeons treat appendicitis in children?
Once the diagnosis of appendicitis is confirmed, emergency surgery to remove the appendix is done. Traditional open surgery has been supplanted by laparoscopic or keyhole surgery, which gives good results in experienced hands, even in small children and in advanced stages of the disease. However, for sudden complications such as a ruptured appendix, a small percentage of children with very early or uncomplicated appendicitis can be treated with antibiotics under close surveillance by a surgeon. Even if you improve without it, there is always the possibility that the appendicitis will recur sometime in the future.
Dr. Harish Jayaram, MBBS, MS (Gen Surg), M.Ch, Pediatric Surgery (PGIMER, Chandigarh), Consultant Pediatric Surgeon and Pediatric Urologist
Dr. Harish Jayaram , Pediatric Surgeon , Pediatric Urologist
Are there possible problems after successful surgery?
Illness-related or treatment-related long-term problems may occur. If the appendix is found to have ruptured with a large amount of pus in the abdomen, there is a small chance that the intestinal loops will become lodged in these areas, causing an obstruction that requires repeat surgery. When performed, surgery-related complications such as wound infection, wound herniation, and intestinal obstruction are minimized.
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