Appendicitis is called inflammation of the appendix of the large intestine, in other words, the cecum. As a rule, this formation is in the place where the small intestine passes into the large. Also, the appendix can be in the small pelvis, subhepatic space and behind the ascending part of the large intestine. Thus, the process is not always located in the lower right section. In some cases, it is on the left. As a rule, adults face this disease. However, children may experience this problem. In the review, we will consider how appendicitis manifests itself in children. Diagnosis, treatment and prevention methods - all these issues will be disclosed in more detail.
Causes of the disease
Let's dwell on them in more detail. What leads to the development of appendicitis in children? The trigger factor may be:
- helminthic invasion;
- frequent constipation;
- dysbiosis;
- abuse of sweets.
The functions performed by the appendix in the body are not yet fully understood. However, for some reason, it can become inflamed. It is believed that the development of appendicitis is associated with blockage of the lumen of the appendix. In addition, pathogenic microflora can become the cause of the disease. Clogging can be caused by worms, a foreign body that has fallen into the intestinal lumen and fecal stones. It also happens that the lumen is blocked due to the overgrowth of the lymphoid follicles contained in the appendix. Congenital anomalies, such as the bends of the appendix, are also of great importance. At the same time, microorganisms from the intestine may remain in the lumen of the appendix. Microbes can get there with lymph or blood. Appendicitis often develops against the background of diseases such as tonsillitis, acute respiratory viral infections, acute respiratory infections and otitis media. Infections of the appendix become caused by infections such as tuberculosis, yersiniosis, and typhoid fever.
Bacteria caught in the lumen of the appendix begin to multiply, causing inflammation. As a result, edema and venous congestion develops in the intestinal walls. Subsequently, this can lead to necrosis of the process, rupture of its walls, ingestion of pus and feces in the abdominal cavity. So peritonitis begins to develop.
How to determine appendicitis in a child? Up to 2 years, this disease is extremely rare. This feature is explained by the nutrition of the child, as well as the insufficient development of lymphoid follicles in the appendix. At this age, the appendix communicates with the intestines with a wide opening. Overlapping it is quite difficult. Closer to 6 years, lymphoid tissue grows. At this time, the likelihood of developing appendicitis increases significantly.
Disease classification
There are two forms of the disease: chronic and acute. Acute appendicitis is divided into several types:
- Appendicular colic: a small inflammation of the appendix, which disappears after 3-4 hours.
- Catarrhal appendicitis: superficial inflammation not accompanied by tissue destruction.
- Destructive appendicitis. Two forms are distinguished here: phlegmonous and gangrenous. The first is characterized by a coating of the inflamed appendix with purulent plaque, which can also accumulate in the process cavity. The cause of the development of gangrenous appendicitis is appendix thrombosis. As a result, the general condition of the body worsens.
- Complicated appendicitis.
Symptoms of the disease in question in babies are different, they depend on factors such as the location of the appendix, the stage of inflammation and the age of the child. For this reason, the diagnosis of appendicitis in children at home can be significantly difficult.
Signs
What should you pay attention to first of all? It is only a qualified doctor who can accurately determine that a child has appendicitis. However, parents can pay attention to some symptoms. They mainly depend on the age and individual characteristics of the baby's body.
Signs of appendicitis in children 5 years old:
- lethargy;
- refusal of food;
- lack of interest in games.
The first symptom is severe pain. The kid himself, without realizing it, may try to protect a sick part of the body. He tightens the legs, lies on his right side, resists palpation.
An obvious sign is also an increase in body temperature to 38 degrees and above. Heart palpitations, pallor of the skin, loose stools, and vomiting may appear. The younger the child, the more often the urge to vomit will appear. As a result, dehydration develops.
You should also take into account specific symptoms that may occur with an atypical location of the appendix. So, for example, pain appears in the lower back or inguinal region. In addition, there are problems with urination and excrement. If the appendix is under the liver, the entire right hypochondrium may hurt.
How to determine that a child has appendicitis? Symptoms in children of 5 years are blurry. Inflammatory processes are fast enough. The child begins to behave uneasily, he has no appetite. Stool and urination begin to hurt. The kid does not allow himself to be examined normally and pulls his legs to his stomach.
At 5 years old, appendicitis in a child usually develops suddenly. It proceeds, as a rule, with lightning speed, and manifestations in this case can be atypical. The child is not always able to accurately indicate the location of the pain. As a rule, he points to the area near the navel or to the entire stomach. The symptoms listed above are far from always observed in children. The process of inflammation can rapidly worsen, passing into peritonitis. In this case, the temperature rises to 40 degrees, the stomach swells, there is a delay in stool.
The danger of developing this condition is that many parents believe that appendicitis cannot occur at such an early age. They explain pain by poisoning, overeating, and other causes. If you do not urgently help the baby, the process can burst, which will lead to complications.
Appendicitis in a child at 7 years old is much easier to identify. The kid is already able to accurately indicate the sore spot. As a rule, at the beginning of the development of the inflammatory process, the pain is localized in the umbilical and epigastric regions. After 2-3 hours, it falls into the right iliac part. Pain at the subhepatic location moves to the right hypochondrium. With a pelvic arrangement, unpleasant sensations appear in the suprapubic region. Pain with appendicitis is permanent. This condition clearly leads to sleep disturbance. As a rule, the child refuses to eat, vomiting may also occur. A frequent manifestation of appendicitis is stool retention. In addition, the pulse increases significantly. The pelvic location of the appendix causes rapid urination. Catarrhal appendicitis is accompanied by the appearance of white plaque on the root of the tongue. The risk of developing the disease increases significantly with age.
Appendicitis in a child of 10 years old is observed quite often. Despite the fact that the process most often develops according to the classical version, it is sometimes very difficult to make a diagnosis. A child, even with abdominal pain, may continue to attend school. The process gradually develops until the condition sharply worsens to the stage of complicated appendicitis. In childhood, a chronic form of the disease is not so common. It is characterized by the development of recurrent seizures in the area of the projection of the location of the process. Nausea and fever are also possible.
What could be the consequences?
In order to prevent the development of complications, it is necessary to diagnose the disease in time and undergo treatment. If this is not done, a number of complications can develop.
These include:
- Breakthrough or perforation of the process: this condition usually causes inflammation of the peritoneum, or peritonitis.
- Appendicular infiltrate.
- Bowel obstruction.
- Appendicular abscess (abscess): occurs in the area of the location of the inflamed process.
- Sepsis (the ingress of microorganisms from the inflamed appendix into the blood, their entry into organs and the formation of ulcers).
Diagnosis of the disease
What is she like? How to determine appendicitis in children? Diagnosis is usually carried out by several methods at once. First, the doctor palpates the stomach. With appendicitis, pain is usually observed in the right iliac region. A laboratory examination, including urine and blood tests, will also be required. If necessary, bacteriological examination of feces is still carried out.
Instrumental diagnostic methods include:
- Ultrasound of the pelvic organs and abdominal cavity;
- electromyography;
- CT scan;
- X-ray examination;
- diagnostic laparoscopy.
Girls in childbearing age may still need to consult a pediatric gynecologist.
On palpation, the doctor will determine the pain (local or spilled), abdominal retention during breathing, excessive tension of the abdominal muscles, and irritation symptoms. Parents should never try to detect appendicitis in children. Diagnosis should only be carried out by a qualified professional. Here you need to have some experience. Sometimes small patients are checked during sleep. Also, a doctor may require a rectal digital examination for an accurate diagnosis. Thus, it is realistic to identify soreness and overhanging of the anterior wall of the rectum.
The results of blood tests for appendicitis usually show an increased number of white blood cells, as well as an increase in the number of neutrophilic white blood cells. Protein and red blood cells can be detected in the urine. At 5 years old, appendicitis in a child can be determined by applying electromyography. This type of study helps to identify muscle tension in the anterior abdominal wall. The most accurate diagnostic method is an ultrasound scan. It is it that allows you to determine the acute degree of appendicitis, as well as detect the presence of infiltrates and abscesses in the abdominal cavity.
Appendicitis therapy
So what is its feature? How to treat appendicitis in children at age 7? In this case, parents should follow a few simple recommendations:
- When there is pain in the abdomen, pain medications should not be used on their own. Reception of such funds can significantly complicate the diagnosis.
- The child should not be given laxatives and an enema.
- It is not recommended to apply heating pads or cooling compresses to the stomach. They can affect the rate of development of the inflammatory process.
- Do not let your child drink plenty of fluids. If an operation is required under anesthesia, 3 hours before it, you can not eat food and liquid. With a pronounced thirst, you can simply moisten the child’s lips.
- If you experience sharp abdominal pain, you should immediately consult a doctor.
Treatment usually involves surgery. Both acute and chronic appendicitis require surgery. Appendicitis in a child can be removed both by traditional and laparoscopic methods. Both types of intervention are performed under general anesthesia. The duration of the operation is 30-60 minutes. With timely handling, the prognosis is quite favorable. After surgery, the child should not drink liquid for some time. The exact instructions for the subsequent meal will be given by the surgeon. 5-8 days after surgery, small patients are usually discharged.
Laparoscopic surgery is more preferable because it is not so traumatic. The surgeon will simply make a small incision, then with the help of a telescopic camera and special tools will remove the inflamed appendix. After such an operation, the child recovers much faster. However, in the presence of complications, surgery is usually performed in an open way.
Treatment of appendicitis in a destructive form
What you need to know about this? The operation is much more difficult if the disease is accompanied by complications. With a destructive form, the removal of appendicitis in children requires special preoperative preparation. Within 2-4 hours, intravenous fluids are administered to relieve intoxication. It is also necessary to introduce antibiotics to the small patient. During the operation, doctors clean the entire abdominal cavity, remove mucus, bacterial microflora and feces. In this case, a large number of antibacterial drugs are used.
Postoperative hospital stay in this case will be longer. After discharge, you need to monitor the condition of the child. If fever or other symptoms appear, consult a doctor immediately.
Perforated appendicitis in 20% of cases ends with complications. After the operation, an abscess may develop in the abdominal cavity. Treatment of this condition is selected depending on the individual characteristics of the body. As a rule, it includes taking antibiotics, detoxification therapy, and removing pus from the abdominal cavity. Often after destructive appendicitis, adhesive disease develops.
Preventative measures
Is it possible to somehow prevent appendicitis in a child at 4 years old? Of great importance in this case is the observance of a proper diet. Parents should take their baby’s diet seriously. Frequent use of such harmful products as sweets, chocolate and chips provokes the development of the disease. It is also necessary to monitor the regularity of the stool. All diseases in acute and chronic form in a child must be treated with high quality, avoiding the development of complications. A simple angina can become a trigger for the development of appendicitis in childhood.
Recommendations to parents and reviews
What is the danger of appendicitis? Symptoms in children at 10 years of age may not be so pronounced, which increases the risk of making an erroneous diagnosis. A child cannot always describe in detail how he feels where the pain is specifically localized. While doctors sort through possible options, inflammation begins to progress and reaches a dangerous stage. Therefore, parents should know a few obvious signs. Initially, acute abdominal pain usually occurs. It can be localized in any area, but most often it is concentrated on the right. A forced posture usually helps to reduce a child’s pain. The inflammatory process is often accompanied by vomiting. Usually, after it, the child does not feel better. Particular attention should be paid to this, since vomiting poisoning usually leads to relief.
How else can appendicitis be detected? Reviews of parents whose babies suffered the disease indicate that the symptoms in children at 7 years old will differ from the signs of the disease in adolescents. The inflammatory process in babies, as a rule, is accompanied by a sharp increase in temperature. The older the person, the less pronounced increase in temperature. The course of inflammatory processes can also be judged by the appearance of the tongue. At the stage of the development of the disease, a light white coating forms on it, with the appearance of complications, the entire surface is covered with a dense yellowish film. In the case of necrosis, dry mucous membranes are felt.
How else can a preliminary diagnosis of appendicitis in children at home be carried out? Parents should definitely pay special attention to the occurrence of problems with the stool. As a rule, babies usually develop diarrhea. In older children, disorders are more often expressed in the appearance of constipation. If the cecum is in close proximity to the urethra, then difficulties arise in this area.
Finally
How to treat appendicitis in children? Diagnosis of the disease should be carried out only by professional specialists. However, parents can pay attention to some signs. If the child complains of persistent abdominal pain, then an ambulance must be called urgently. According to the results of the examination, the medical team will decide on the delivery of the child to the surgical department. The further course of action will be determined by the surgeon, the doctor of ultrasound diagnostics and the anesthetist. If necessary, you may still need to consult a gynecologist. If the diagnosis is confirmed, the child will be prescribed surgery. In most cases, with timely treatment, it passes without serious complications.
Appendicitis is actually a serious ailment that can lead to negative consequences if it is not started to be treated on time. Therefore, at the first manifestations, immediately contact a medical institution.