How to Tell If Your Child Has Appendicitis

February 28, 2024

University Hospitals Rainbow Babies & Children'sExperts in Children's Health

Abdominal pain is a common complaint in children, and most of the time the cause isn’t serious. However, when the pain is increasingly intense and accompanied by vomiting or other symptoms, it could be a sign of appendicitis – which requires urgent medical attention.

Appendicitis – or when the appendix becomes inflamed or infected – is actually fairly common in children, and is one of the top reasons for emergency abdominal surgery in children, explains University Hospitals Rainbow Babies & Children’s pediatric surgeon and Director of Pediatric Trauma, Michael Dingeldein, MD.

The appendix is a small structure attached to the end of the colon, and it doesn’t serve any known purpose in humans. The opening of the appendix is small, making it prone to getting blocked. When this happens, the appendix becomes swollen and infection can develop. This becomes especially dangerous when the appendix ruptures or bursts, causing the infection to spread to the belly.

Appendicitis can affect children of all ages, though it is less common in children under the age of 3 and rarely affects children under 1 years old. It most commonly occurs in children ages 5 – 10.

Signs to Look For

Because belly pain is a vague symptom with many potential causes, it can be tricky for parents to determine whether their child’s abdominal pain is a sign of appendicitis or something else. Appendicitis usually starts out as a vague discomfort around the belly button, which then migrates to the lower right side of the belly. The pain may be accompanied by nausea, vomiting, diarrhea, or a fever.

Parents should also be on the lookout for behavioral signs that something is amiss, especially in younger children who may not be able to communicate their symptoms effectively. This can include signs such as irritability or having no interest in eating, not even their favorite foods.

“I’ll often ask patients what their favorite food is and if they want to eat it right now,” says Dr. Dingeldein. “If they answer no, that’s a good indication that something is wrong.”

Appendicitis pain often gets worse with movement or activity, due to inflammation of the abdominal cavity’s lining (peritoneum). So another thing parents can try is the “jump test”. As the name suggests, this involves having the child try to jump. If jumping makes the pain worse, it could be a sign that the peritoneum is inflamed, which may indicate appendicitis.

When to Seek Care

If your child displays any of these symptoms, it warrants an urgent trip to their pediatrician, says Dr. Dingeldein.

Your child’s doctor will be able to take a medical history and perform a physical exam. While appendicitis can often be diagnosed with history and exam alone, your child may also undergo additional tests such as:

Blood work
Ultrasound
Computed tomography (CT) scan

Surgery and Recovery

If your child is diagnosed with appendicitis, the first step will be to put them on antibiotics to stop the infection from getting worse. Surgery to remove the appendix will usually be scheduled within 6 – 12 hours.

“It’s incredibly rare that there is a need for an immediate emergency surgery,” says Dr. Dingeldein.

In some cases, your child’s doctor can attempt to treat appendicitis with antibiotics alone. However, there’s a chance of recurrence within the next 10 years, so most parents opt for the surgical removal of the appendix, or an appendectomy. This minimally invasive laparoscopic surgery uses tiny incisions in the abdomen to remove the appendix. In uncomplicated cases in which the appendix hasn’t ruptured, the patient may be able to return home the same day and can return to school and sports within a couple of weeks. However, if the problem isn’t caught quickly enough and the infection has spread, it may require a longer hospital stay.

“This is why it’s so important to recognize those early signs and seek medical care if you suspect appendicitis,” says Dr. Dingeldein. “The earlier we catch it, the easier it is to treat it and get your child healthy again.”