Acute appendicitis in children

Acute appendicitis is an urgent pathology of abdominal surgery, which consists in inflammation of the appendix.

This disease is the most common reason for a child to go to a surgeon.

The key to successful treatment is early diagnosis.

[1], [2], [3], [4], [5], [6], [7],

Epidemiology

Acute appendicitis is the most common surgical disease in children (4: 1000).

[8], [9], [10], [11], [12], [13]

Symptoms of the acute appendicitis in a child

In children of school age and adolescents appendicitis develops more often than in preschool children and often have clinical signs similar to adults. In younger children, the disease is especially difficult to diagnose, because it is accompanied by nonspecific signs.

Symptoms of acute appendicitis in children are extremely diverse and variable depending on the age of patients and the characteristics of reactivity, the severity of the inflammatory process, the location of the process in the abdominal cavity.

In preschool and schoolchildren, pain often occurs in the epigastrium or near the navel and only a few hours later is localized in the right ileal region. Pain usually has a constant aching character. Vomiting and nausea are frequent but not permanent symptoms of acute appendicitis. Body temperature normal or subfebrile. The general condition of children with acute appendicitis deteriorates as the inflammatory phenomena increase. The tongue is coated with a white bloom. Symptoms of irritation of the peritoneum (Shchetkin-Blumberg, Sitkovsky, Rovsinga) are less reliable in children than in adults. Characteristic:

• muscle tension of the right iliac region when palpating the abdomen;
• increase rectal temperature by more than 1 ° C compared with the axial one;
• tachycardia not corresponding to body temperature;
• in the blood - leukocytosis, neutrophilia with a stab-shift, an increase in ESR.

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Diagnostics of the acute appendicitis in a child

Laboratory tests, ultrasound, computed tomography or magnetic resonance imaging are the main ones in the diagnosis of appendicitis at this age.

[15], [16], [17], [18], [19]

Treatment of the acute appendicitis in a child

Suspicion of acute appendicitis requires the involvement of a child surgeon to monitor the child. Treatment of acute appendicitis in children is surgical.