APPENDICITIS |
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DESCRIPTIONAppendicitis is inflammation of the vermiform appendix, a small tube that extends from the cecum, the first part of the large intestine. The appendix has no known function, but it can become diseased. Appendicitis affects 1 in 500 people each year. The appendix, cecum, and peritoneum (the membrane covering the intestinal tract) are involved. Appendicitis is rare in children under 2. The peak incidence is between ages 15 and 24.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Surgery to remove the appendix. Because appendicitis can be hard to diagnose, surgery is often withheld until symptoms and signs progress enough to confirm the diagnosis.
SIGNS & SYMPTOMS
Pain that begins close to the navel and migrates toward the right lower abdomen. The pain becomes persistent and well localized. It worsens with moving, breathing deeply, coughing, sneezing, walking, or being touched.
Nausea and vomiting (sometimes).
Constipation and inability to pass gas.
Diarrhea (occasionally).
Low fever, beginning after other symptoms.
Tenderness in the right lower abdomen, usually about a third of the distance from the navel to the top of the hip bone. (This description applies only if the appendix is in its normal position. In some cases, the tip of the appendix is located elsewhere, making diagnosis difficult.)
Abdominal swelling (late stages).
Increased white blood cell count.
CAUSES
Infection for unknown reason, usually with bacteria from the intestinal tract. The appendix may become obstructed from contents moving through the intestinal tract or by a constricting band of tissue. When infected, it becomes swollen, inflamed, and filled with pus.
RISK FACTORS
Recent illness, especially a roundworm infestation or gastrointestinal virus infection.
PREVENTING COMPLICATIONS OR RECURRENCENo specific preventive measures.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam (maybe several) by a doctor.
Laboratory blood studies. Tests usually show higher levels of white blood cells.
Urinalysis to rule out a urinary-tract infection, which can mimic appendicitis.
X-ray of the abdomen.
POSSIBLE COMPLICATIONS
Rupture of the appendix, abscess formation, and peritonitis. This is most common in older persons, not children.
Misdiagnosis because of few or atypical symptoms--especially in the very young (or very old).
PROBABLE OUTCOME
Usually curable with surgery. If totally untreated, a ruptured appendix is fatal.
TREATMENT
HOME CARE
While the diagnosis is uncertain, take your child's rectal temperature every 2 hours. Keep a record for your doctor. Don't let the child eat or drink until the diagnosis is certain.
MEDICATION
Don't give your child any laxatives, enemas, or medicines for pain. Laxatives may cause rupture, and pain- or fever-reducers make diagnosis more difficult.
ACTIVITY
Your child should rest in a bed or chair until surgery.
DIET & FLUIDS
Don't let the patient eat or drink anything until appendicitis has been diagnosed. Anesthesia for surgery is much safer if the stomach is empty. If your child is very thirsty, wash his mouth out with water.
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of appendicitis.
The following occurs while surgery is pending:
--Fever spikes (rises suddenly) to 102F (38.9C) or over.
--Continued vomiting.
--Increased pain in the abdomen.
--Fainting.
--Blood in the stool or vomit.
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