Appendicitis: symptoms in children - how to recognize an attack. Features of acute appendicitis in children: symptoms and treatment

When a child has a stomach ache, many experienced mothers, even before the doctor arrives, begin to assume - indigestion, poisoning, eating new, unfamiliar foods. Diagnosis is complicated if the child is small and cannot show exactly where it hurts and cannot tell about the nature of the pain. In such cases, some mothers begin to suspect appendicitis with fear. Of course, only a doctor can confirm or refute the diagnosis, but parents should be able to distinguish between some primary signs appendicitis and, if necessary, urgently take the child to the hospital. Today we will talk about the features of the course of appendicitis in children, the symptoms and causes of the disease, as well as the surgical treatment of inflammation.

Features of the course of appendicitis in children

Many mistakenly believe that appendicitis occurs only due to intestinal blockage when a person consumes seeds and nuts with husks. Moreover, there is a myth that children do not get appendicitis. But it's not. Of course, the appendix can become inflamed due to the ingress of food debris into it, but this is far from the only reason. Appendicitis can become inflamed even in infants who have never tasted anything other than mother's milk.

Appendicitis is an inflammation of the appendix, a small appendix blind gut. Inflammation can be caused by various reasons - we will talk about them a little later. Most often, appendicitis develops in adolescents - 13-19 years old. Less often, the appendix can become inflamed in children of primary school age. Appendicitis can also affect a baby, but this is extremely rare.

The peculiarity of the course of appendicitis in children is that the disease develops extremely quickly. Everyone knows that with appendicitis, you need to see a doctor as soon as possible. Surgery can save a person from peritonitis - another effective treatment appendicitis simply does not exist. In the case of children, you need to respond as quickly as possible. The fact is that some organs and parts of the peritoneum in children are not developed and are formed only by adolescence. We are talking about a large omentum, which is formed only during puberty of a teenager. He is able to protect and, as it were, fence off the inflamed area. Because the babies big omentum not yet developed, appendicitis proceeds rapidly, until the last without making itself felt.

Among the features of the course of appendicitis in children is the localization of pain. In adults, "appendicitis" pain is located with right side below the navel. Structural features of the child's body suggest that pain in appendicitis will be localized above the navel - in infants by 3-4 cm, in children under three years old - by 2 cm, in a child of 10 years old - by only 1 cm. As human organs grow , as well as the appendix, are displaced. So what symptoms in a child can tell about a possible appendicitis?

How to recognize appendicitis in a child

Here are some symptoms to watch out for parents.

The very first thing that will happen to a child is that he will feel worse. This may be accompanied various symptoms- apathy, tearfulness, bad mood, refusal to eat, etc. From this moment on, the mother should monitor the baby more closely and pay attention to the accompanying manifestations and signs.
Appendicitis is necessarily accompanied by pain in the abdomen. The child may complain of spatial pain in the abdomen. Often children, especially small ones, do not indicate the exact localization of pain, they say that the stomach as a whole hurts. In some cases, pain can radiate to the sides, pelvis, and even the spine.
Finding out what and where the child hurts, try to calm the child and calm down yourself, often older children can lie and not complain about pain until the last, as they are afraid of surgery, hospitals, doctors, etc.
It is important to understand that inflammation can develop in a matter of hours and will make itself felt unexpectedly. The stomach can immediately start to hurt a lot at school or kindergarten, on the street, etc.
If the pain in the abdomen is minor, follow the child for a while. On the first night, the child may not sleep well, he constantly screams, cries, whimpers, moans.
Try to touch the child's stomach - if he pulls your hand, pulls away, screams sharply in pain, most likely it is appendicitis.
It is extremely difficult to diagnose inflammation in young children in the first months of life, since many of the symptoms can be similar to infantile colic. Unfortunately, in most cases, appendicitis in infants is diagnosed after peritonitis.
The baby should be monitored very carefully. With appendicitis, the baby cries constantly, regardless of the time of day. With colic, children usually act up and cry at the same time of day. The baby can tuck his legs under him, twists them, cries out when he touches his stomach, tries to lie on his left, painless side.
Very often, appendicitis at any age is accompanied by profuse vomiting and a feeling of nausea, diarrhea. With diarrhea, mucus may be present in the stool. Sometimes stool disorders can be caused not by diarrhea, but, on the contrary, by constipation.
The inflammation can be so extensive that the pain goes to genitourinary system. Older children may complain of pain when urinating, young children simply cry in the process.
like anyone inflammatory process, appendicitis is accompanied by an increase in body temperature. It can be like a long subfebrile temperature, not exceeding 37.5 degrees, and very high up to 40 degrees. But not in all cases, the temperature can be considered a fundamental symptom, sometimes appendicitis occurs without its increase.
A child with appendicitis may become pale, often accompanied by excessive thirst and dry mouth.
With mild pain, the child can squat down during the game and press right leg to the abdomen in search of a comfortable, pain-free position.
Another way to identify appendicitis in a child is to feel his stomach. In a healthy baby, the abdomen should be soft. A hard and tense stomach indicates inflammation.
In the acute stage of appendicitis, the child will not be able to stand up straight and walk even a few steps - this will bring him severe pain on the right side of the abdomen.
Since diagnosing appendicitis in a child is always difficult, doctors use this method. The baby needs to be put on a flat surface, raise the right leg and bend it at the knee. If, at the same time, a sharp pain in the right side of the abdomen pierces the child, there is no doubt that this is appendicitis.

If you notice at least a few of the above symptoms in a child, you need to see a doctor as soon as possible to clarify the exact diagnosis.

Causes of appendicitis in children

The causes of inflammation of the appendix are in many ways similar to adult appendicitis, let's try to consider them in more detail.

In order for the appendix to become inflamed, two conditions must be met - the entry of a pathogenic infection into the rectal cavity and clogging of the process. The first can occur in case of poisoning, ingestion of microbes, bacteria.
Blockage of the process may occur by various reasons- from a banal feature physiological structure appendix to obstruction by foreign objects. The passage to the appendix can be closed by feces, the remnants of undigested food - the husks of seeds, nuts, etc.
The risk of developing appendicitis increases if the child's body is weakened and unable to resist the inflammatory process. Immunity can be reduced due to frequent illnesses, not proper nutrition, constant overheating of the child.
Appendicitis in children often occurs due to foreign objects entering the intestines. It happens that children eat berries with seeds, it can get into the body fish bone or in general, a small detail from a toy. This can cause blockage of the process.
Sometimes blockage of the process can occur against the background of active reproduction of helminths in its cavity.

In general, even doctors cannot say with accuracy what caused the inflammation of the appendix in this or that case. The above symptoms are very conditional and only increase the risk of developing appendicitis, although they cannot fully explain the problem.

If you notice some of the symptoms in your child, which we told you about above, you need to act immediately. It is better to play it safe and refute the diagnosis in the hospital than to hope for the best and wait for complications at home.

If you suspect a child has appendicitis, you need to get to the hospital as soon as possible, where there are operating surgeons. Consider whether it is appropriate to call ambulance or you can get to the hospital faster with your car. In no case should you give your child antipyretics, painkillers, laxatives or other drugs that can reduce the severity of the symptoms of the disease. This will make it difficult to make a correct diagnosis.

In addition, in no case should you give your child drugs for the intestines - the compositions of some can provoke a rupture of the inflamed appendix ahead of time. Also, try not to give anything to drink or feed the child, because you may need an urgent operation. Another prohibition - do not apply to the sore side hot compress until you know the exact diagnosis. With appendicitis, heat will only increase the inflammatory process. You need to beware of any warming procedures - a hot enema, sitting in a bath with hot water etc. But you can apply cold, this will narrow the blood vessels and reduce the manifestation of pain. Wrap a piece of ice or frozen meat in a bag and a towel, attach it to your stomach - where the pain is the most.

You need to put the child in a comfortable position that causes him less pain, and then take him to the doctor as soon as possible. If the doctor confirms the diagnosis of appendicitis, the baby will have surgery.

Afraid surgical intervention no need. To date, the operation to remove the inflamed appendix is considered one of the simplest and most common. Several decades ago there were attempts conservative treatment appendicitis - inflammation was healed with antibiotics, etc. However, to date, such treatment is ineffective for several reasons. Firstly, after such exposure, sooner or later, the appendix still starts to hurt again - the inflammation resumes. The second reason is that the process can break at any time, this big risk. Another reason is that inflammation becomes chronic, it is expressed with fewer symptoms, but slowly affects neighboring organs - the rectum, peritoneum, etc. By removing the unnecessary process surgically, we solve this problem once and for all.

Complications of appendicitis are deadly. If the pain suddenly stops, it may indicate serious consequences, most likely, peritonitis occurred - the intestine ruptured and its contents entered the abdominal cavity. To prevent this, you need to see a doctor as soon as possible.

How to protect your child from appendicitis

As noted, appendicitis in children can occur for various reasons. To protect your child from inflammation of the appendix, you need to follow a few rules of prevention.

Nutrition should be correct, balanced, according to the age of the child.
It is necessary to prevent the development of constipation, especially chronic. To do this, you need to eat more fiber, consume dairy products, limit the intake of simple carbohydrates, drink more pure water. After all, fecal stones that form during long-term constipation are most often the cause of blockage and inflammation of the appendix.
Monitor the health of the gastrointestinal tract - do not overeat, treat diseases of the stomach and intestines in time, regularly do fasting days, cleanse the intestines with laxative foods.
Watch the child so that he does not take foreign objects into his mouth. Keep all small parts of toys out of reach. Make sure that the child does not swallow fruit seeds and other objects that need to be spit out.

These rules do not guarantee you one hundred percent protection against appendicitis, but they are quite capable of reducing the risk of its development.

Appendicitis is a complex and mild disease at the same time. On the one hand, surgery to remove appendicitis is quite simple, postoperative period short - a person quickly recovers. On the other hand, diagnosing appendicitis is quite difficult, especially if parents associate abdominal pain with food poisoning and do not take the child to the hospital until the last. Delay can cost the baby his life. Therefore, do not be shy and do not be lazy to once again seek medical help. Take care of the child, because he has no one else to rely on.

Video: symptoms of appendicitis in children

Appendicitis is an inflammation of the appendix, or caecum (the appendix of the large intestine). Most often, the process is located at the junction small intestine into thick. But the appendix can be located in the subhepatic space, and in the small pelvis, and behind the ascending colon. Moreover, the process is not always located in the right lower abdomen - it can also be located on the left. It is believed that this disease occurs more often in adults, but in this article we will look at the symptoms, causes and treatment of appendicitis in children.

Reasons for the development of appendicitis

Predisposing factors for appendicitis are constipation, dysbacteriosis and helminthic infestations, as well as the abuse of sweets.

Since the functions of the appendix have not been fully elucidated, there are supposedly several reasons for its inflammation. It is believed that inflammation of the appendix develops as a result of blockage of the lumen of the process and exposure to microflora. Obstruction (blockage) can be caused by fecal stones, helminths, a foreign body that has entered the intestinal lumen.

Overgrowth of the lymphoid follicles that form it can also block the lumen of the process and connect it to the intestine. May be important and congenital anomaly(bends) of the process. At the same time, microorganisms from the intestine remain in the lumen of the appendix.

Microbes with blood or lymph can also be brought there, because appendicitis often develops after suffering a sore throat, otitis media, SARS, acute respiratory infections and other diseases. Some infections (yersiniosis, tuberculosis, typhoid fever, etc.) cause inflammation of the process.

Bacteria in the lumen of the appendix multiply and cause inflammation; mucus secretion increases, edema develops and venous congestion in the intestinal wall. In the future, this can lead to the development of necrosis (necrosis) of the process, rupture of its wall and the ingress of intestinal contents (pus and feces) into the abdominal cavity - peritonitis develops.

Predisposing factors for the development of appendicitis in children can be constipation, helminthic invasions, overeating, abuse of sweets, dysbacteriosis, insufficient intake of fiber from food.

Before the age of 2 years, appendicitis rarely develops (although it can also occur in a newborn). This is due to the nature of the child's nutrition and insufficient development of lymphoid follicles in the process itself. The appendix, due to this underdevelopment, communicates with the intestines with a wide opening, which is difficult to block. And by the age of 6, the lymphoid tissue matures, and the incidence of appendicitis increases.

Classification of appendicitis in children

There are acute and chronic appendicitis.

Varieties of acute appendicitis:

Appendicular colic: mild inflammation of the appendix, which disappears after 3-4 hours.
Catarrhal appendicitis: simple, superficial inflammation of the appendix without tissue destruction.
Destructive appendicitis:

Phlegmonous appendicitis (with or without perforation): the inflamed process is covered with purulent plaque, with ulceration of the mucous membrane and accumulation of pus in its cavity; with purulent or cloudy effusion in the abdominal cavity.
Gangrenous appendicitis (with or without perforation) develops as a result of thrombosis of the vessels of the appendix: a dirty green process with fetid odor and effusion; accompanied by heavy general condition child.

Complicated appendicitis.

Symptoms of appendicitis in children

Manifestations of appendicitis in children are very diverse and depend on age, the location of the process itself and the stage of its inflammation.

A small child becomes lethargic, not interested in toys, refuses to eat. The very first sign of appendicitis is pain. The kid tries to protect the painful place: he often lies on his left side, draws up his legs, kicks his legs, cries when he is picked up, resists examining the abdomen (repels his hand).

The child's temperature rises to 38 ° C, and sometimes even higher. The child is pale, the heartbeat is quickened, vomiting and loose stools appear. The younger the child, the more often vomiting; can quickly develop dehydration small child manifested by intense thirst.

The greatest difficulties in recognizing appendicitis in children 3-4 years old: it occurs suddenly, the manifestations are not always typical, and the course can be lightning fast. Children can not always clearly show the place where exactly they have pain in the abdomen. Most often they point with a pen to the navel or point to the entire abdomen.

Children do not necessarily show all of the symptoms listed above. The process of inflammation of the process can be aggravated rapidly, and after a few hours peritonitis may develop. In this case, the pain spreads to the entire abdomen, the child is pale, the temperature rises to 40 ° C, the abdomen is swollen, and stool retention may be noted.

The danger is also that many parents believe that appendicitis does not happen at this age, and they attribute these manifestations to overeating, poisoning, and other causes. And some even begin to treat the baby on their own. Without surgical treatment, the process may burst (this occurs in 25-50% of children), which leads to complications, long-term treatment in the hospital.

From the age of 6-7 years, the child is able to indicate the place of pain in the abdomen. In the classical version of the development of the process, pain is first localized in the epigastric region or paraumbilical, and then (after 2-3 hours) descends to the right iliac region (projection of the location of the process). With a subhepatic location, its pain shifts to the right hypochondrium, when located behind the caecum, pain in the lower back bothers, with a pelvic location, pain is noted in the suprapubic region.

The nature of pain in appendicitis is constant, without contractions, the pain is not sharply expressed. Constant pain leads to sleep disturbance. Pain does not cause the child to rush about. The child refuses to eat. Very often there is a single or double vomiting. Possible stool retention.

The temperature is increased within 37.5 C; sometimes rises to high numbers, but may remain normal. For senior age group Children are characterized by a discrepancy between pulse and temperature. Usually, when the temperature rises by 1 degree, the pulse quickens by 10 beats. And with appendicitis, the pulse significantly exceeds the temperature increase.

With the pelvic location of the appendix, frequent urination is noted. With catarrhal appendicitis, the tongue is moist, lined at the root with a white coating; with phlegmonous - it is also wet, but completely lined; with gangrenous - the tongue is dry and all lined.

The age of high risk for the development of appendix inflammation is the age from 9 to 12 years - the most common group of children suffering from appendicitis. Despite the frequent development of the process according to the classical version, it is more difficult to make a diagnosis in children than in adults. At this age, the child can continue to attend school, although the stomach hurts. But the process continues to develop, and the child's condition may deteriorate sharply already at the stage of complicated appendicitis.

chronic appendicitis in childhood less common than in adult patients. It is characterized by the appearance of recurrent attacks of pain in the projection area of the appendix, with fever and nausea.

Complications of appendicitis

In order to avoid complications, surgical treatment should be carried out in time. If this has not been done, then a number of complications may arise:

perforation (breakthrough) of the process with the subsequent development of peritonitis (inflammation of the peritoneum);
appendicular infiltrate (limited peritonitis, may contribute to the formation of a conglomerate of intestinal loops, omentum and peritoneum);
appendicular abscess (abscess in the abdominal cavity) in the area of the location of the inflamed process or at some distance from it;
intestinal obstruction;
sepsis (generalized disease due to the ingestion of microorganisms from the inflamed appendix into the blood and their entry into various bodies with the formation of abscesses).

Diagnosis of appendicitis in children

On palpation of the abdomen, the doctor will detect pain in the right iliac region, and also check the objective symptoms characteristic of appendicitis, some of which will necessarily be positive.

Various methods are used to diagnose appendicitis:

examination of the child with a feeling of the abdomen; rectal digital examination;
laboratory examination (clinical blood and urine tests), if necessary - bacteriological analysis of feces, coprogram;
instrumental methods: ultrasound of the abdominal cavity and small pelvis, electromyography; in difficult-to-diagnose cases, specialists can use x-ray examination or computed tomography of the abdominal organs (CT), diagnostic laparoscopy(operation through three punctures in the abdominal cavity with the introduction of a telescopic video camera);
consultation of a pediatric gynecologist (for girls of childbearing age).

During examination and palpation (palpation) of the abdomen, the doctor reveals local or diffuse pain, lagging of the abdomen during breathing, tension in the abdominal muscles, as well as special symptoms irritation of the peritoneum (Shchetkin-Blumberg symptom, Voskresensky symptom, Rovsing symptom and others).

Parents should not deal with the diagnosis or exclusion of appendicitis on their own: in order to evaluate the symptoms mentioned, you need to have experience in identifying and comparing them. In young patients, it is sometimes necessary to check for symptoms during sleep. With a rectal digital examination, the doctor reveals soreness and overhanging of the anterior wall of the rectum and excludes other diseases.

A blood test reveals an increase in the number of leukocytes in appendicitis, an increase in the number of neutrophilic leukocytes. In the analysis of urine, erythrocytes, leukocytes, protein can be noted as reactive, secondary reactions of the body.

In young children, electromyography is sometimes used to detect muscle tension in the anterior abdominal wall. More exact method diagnosis of appendicitis (95%) - ultrasound: the method allows not only to diagnose acute appendicitis, but also to detect the presence of fluid in the abdominal cavity, infiltrates and abscesses.

Sometimes diagnosis requires dynamic surveillance for the child of a surgeon within 6-12 hours in a hospital.

Treatment

Basic rules for parents:

If you experience pain in the abdomen, you can not use any painkillers (including no-shpas) on your own - these drugs can make it difficult to diagnose the disease.
Do not give the child an enema or give a laxative.
You should also not use a heating pad on the stomach - neither hot nor cold; they can influence the rate of development of the inflammatory process.
It is not recommended to give the child a lot of fluids to drink: if the diagnosis is confirmed, an operation will be performed under anesthesia, and food and liquid consumption is excluded 3 hours before it; with severe thirst, you can simply moisten the lips of the child.
If you experience abdominal pain, you should immediately consult a doctor.

With timely treatment and diagnosis of appendicitis, surgical treatment of the child is carried out. Both acute and chronic appendicitis are absolute indications for surgical intervention. The operation can be performed by open traditional and laparoscopic methods. Both operational way are performed under general anesthesia.

The operation lasts 30-60 minutes. The prognosis for timely surgery is favorable. After the operation, the child should not drink liquids, but can only wet the lips. Only the surgeon allows food intake and determines the nature of this food. In uncomplicated cases, the child is usually discharged for 5-8 days.

The laparoscopic method of surgery is preferable, it is less traumatic: the surgeon makes a small incision (or several) and, using special tools and a telescopic camera, removes the inflamed appendix. The child recovers faster after such an operation. But in the case of complicated appendicitis, the operation is performed in an open way.

With a destructive form of appendicitis, preparation is carried out for 2-4 hours before the operation: infusion therapy is prescribed (intravenous administration of fluids to relieve intoxication), and antibiotics are administered. Technically, this operation is somewhat more complicated, and the postoperative hospital stay is longer. After discharge, the child should be observed so that in case of fever or other symptoms, contact a doctor immediately.

In 15-20% of children operated on for perforated appendicitis, complications develop in the postoperative period (an abdominal abscess is formed). The treatment of such a complication is selected individually (removal of pus from the abdominal cavity, antibiotic therapy, detoxification therapy). Adhesive disease may also develop after destructive appendicitis.

Mortality (mortality) with appendicitis in childhood is 0.1-0.3%.

Prevention of appendicitis

The proper rational nutrition of the child, compliance with the diet is important. Parents should monitor the regularity of bowel movements. Also important is the timely quality treatment any chronic and acute illness The child has.

Summary for parents

The timeliness and extent of surgical treatment for appendicitis, as well as the outcome of the operation and the development or absence of complications, depend on how attentive the parents are to the health of their child, on how quickly they seek medical help for any abdominal pain.

Which doctor to contact

With persistent abdominal pain in a child, an ambulance should be called, which will probably take the child to a surgical hospital. There he will be examined by a surgeon, an anesthesiologist, a gynecologist (if necessary), an ultrasound diagnostician. Once the diagnosis is confirmed, surgery will be performed.

The reasons
Clinical picture
Age features
Diagnostics
First Aid: Helpful Tips for Parents
Treatment
rehabilitation period
Complications
Prevention

Appendicitis is a familiar disease, which is an inflammation of the appendix. This is the name of the appendix of the caecum. This is one of the most frequent pathologies abdominal cavity, which requires mandatory surgical treatment. Without it, numerous complications occur, including death.

Unlike adults, appendicitis in children under adolescence proceeds somewhat differently. This is due to the process of formation of internal organs, which is not yet completed. Parents should keep this in mind in order to recognize the symptoms of the disease in time and call an ambulance as soon as possible.

The reasons

The medical community has been divided into several groups, naming the causes of appendicitis in children: this issue has not yet been fully studied and remains open. Nevertheless, parents should keep each of them in mind in order to protect the life of their baby from provoking factors.

Infection theory

Vascular theory

Systemic vasculitis is inflammation of the blood vessels.

endocrine theory

An increase in the hormone serotonin.

Doctors do not give a 100% guarantee that some of these factors lead to the disease. Until now, more precise causes of inflammation of appendicitis in children are being clarified, which parents could take into account in prevention. While the list is too long and not very true - these are just scientific assumptions. There are no proven facts in the framework of these theories. As for the classification, there are much fewer controversial issues.

through the pages of history. The first removal of the appendix was performed on a child. It happened in Great Britain (London) in 1735. The surgeon of the royal court operated on an 11-year-old boy. Despite the fact that this was the first experience, the operation was very successful: the patient recovered.

Kinds

Appendicitis diagnosed in children different ages may proceed differently. As a result and medical intervention will be different. This disease is classified according to the clinical picture, i.e., symptoms and signs.

Spicy

The most common and dangerous is acute appendicitis in children, characterized by an inflammatory-necrotic process in the body of the appendix. Requires urgent surgery, otherwise it can provoke life-threatening complications. Includes several more types.

Catarrhal (simple).
Surface.
Destructive, which in turn is divided into: phlegmonous (with perforation, i.e. rupture, and without it), phlegmonous-ulcerative, apostematous, gangrenous (with and without perforation), perforative.

Complicated appendicitis is also distinguished, in parallel with which pathologies such as appendicular infiltrate, widespread peritonitis, pylephlebitis, abscesses of the abdominal cavity, liver, and sepsis develop.

Chronic

A fairly rare form of appendicitis in children. A consequence of an acute illness. It is characterized by sclerotic and atrophic pathologies in the appendix. Some scientists believe that primary chronic appendicitis is possible, not due to a previously transferred acute one. Other doctors say that there is no chronic form at all.

The form of the disease is determined already in the laboratory. Parents also need to recognize the first signs of appendicitis in a child in time, without confusing them with the symptoms of a common indigestion. The sooner he is sent to the hospital, the lower the risk of developing life-threatening complications.

Through the pages of Russian history. The first operation to remove the appendix in Russia was carried out only in 1888.

Clinical picture

It should immediately be noted that the signs of appendicitis in children, especially before adolescence, differ from the clinical picture of this disease in adults. The internal organs (including the appendix) are still being formed - this factor is due to age features inflammation.

Up to 3 years

In newborn babies and children under 3 years old, symptoms of acute appendicitis can be distinguished, relating only to general malaise:

sharp crying, distinguished by its monotony;
restless, short sleep;
lethargic state;
refusal to eat;
constant regurgitation;
vomit;
pain in the tummy is manifested by pulling the legs up to it or fast movements them.

At this age, it is very difficult to understand that a child has appendicitis, since pain can be a symptom of any other diseases of the internal organs.

4-7 years old (preschool age)

In young children 5-7 years old, parents should pay attention to the following signs of acute appendicitis:

behavioral changes: whims, crying;
restlessness;
finding a comfortable position that relieves pain;
pulling the legs as close to the stomach as possible;
refusal of any, even the most favorite food;
vomiting: rarely single, more often - repeated again and again;
sometimes - diarrhea, but without mucus and blood;
sleep disorders;
lethargic state;
temperature 37-38°C.

If there is even the slightest suspicion of appendicitis, the preschooler should be immediately taken to the hospital to confirm the diagnosis.

8-12 years old (primary school age)

Schoolchildren can already at least tell which side appendicitis hurts (complaints should be on the right side). This makes it easier to recognize the first signs of inflammation:

diffuse pain throughout the abdomen, then it descends into its lower sections;
localization of pain syndrome - right side;
increased pain when changing position;
nausea flowing into vomiting;
lack of appetite;
subfebrile temperature 37-38°C.

A child at 10-12 years old makes it easier fast diagnostics appendicitis before the arrival of the ambulance. He can tell where exactly he hurts and what the nature of the pain syndrome is.

Adolescence

After 12-13 years, the symptoms of appendicitis in children differ little from the clinical picture of the disease in adults. The appendix is already sufficiently formed, so the body reacts to its inflammation with typical signs:

lack of appetite up to anorexia;
nausea, repeated vomiting of a reflex nature, but both of these symptoms appear with pain, and not before it;
subfebrile temperature 37-38 ° C;
sometimes - frequent urination, liquid stool;
rarely - tachycardia and increased pressure;
white coating in the language;
dry mouth;
thirst;
constrained movements dictated by pain in the right side.

This is what a normal (left) and inflamed appendix looks like

Knowing how the stomach hurts with appendicitis and from which side, parents will be able to quickly diagnose the disease in school-age children on their own. It will be much more difficult with babies in whom the clinical picture of the disease is in the nature of a general malaise and requires laboratory diagnostics. This is the age-related features of the course of this disease.

Wow! In 1959, the Russian doctor who worked on the ship, Kalinichenko, performed an operation to remove the appendix in almost unrealistic conditions - at that time a 12-point storm was raging. But that's not all! The surgeon performed it himself!

Age features

Age-related features of appendicitis in children are mainly associated with the clinical picture of the course of the disease, which is described above. And it is already due to the formation and development of the appendix, prone to inflammation.

Up to 3 years

Many people ask if appendicitis occurs in young children: at this age, this disease is very rare. This is due to the fact that the lumen of the appendix is still very small, while lymphatic system underdeveloped. By its structure, this internal organ in children under 3 years of age only vaguely resembles an adult. The diagnosis is most often confirmed only during surgery.

4-7 years old

The clinical manifestations of acute appendicitis at this age are not similar to the symptoms of adults. In children 5-6 years old, the danger of the disease lies in the difficulties of diagnosis. Its symptoms are easily confused with those of other pathologies. because of young age the baby can not explain what exactly hurts him. The disease develops rapidly. Unfortunately, it is for this reason that the risk of mortality from appendicitis at this age increases.

8-12 years old

Acute appendicitis in children aged 8-9 years proceeds with minor differences from the disease in adults. main reason, according to studies, are presumably helminths and wrong job stomach.

Adolescence

In adolescent children, acute appendicitis manifests itself in the same way as in adults. The main cause of inflammation of the appendix at 13-16 years old, according to scientists, is changes hormonal background associated with puberty.

Given these age characteristics, parents should pay considerable attention to appendicitis in young children, in particular - if they are not yet 3 years old. In case of any suspicion, it is necessary to immediately call the ambulance team, where the baby will be fully diagnosed.

Innovations of modern medicine. In Sweden in 2008, a unique operation removal of the appendix - transgastric appendectomy. Its unusualness is that after it there is no scar and scar. The instrument is passed to the desired location through an incision in the stomach. To date, this practice is still experimental.

Diagnostics

Knowing how to identify appendicitis in a child by the first symptoms of the disease, parents will not miss the dangerous moment and take him to the hospital as soon as possible. There, the diagnosis will be carried out by qualified doctors using various methods.

Palpation of the abdomen.
More accurate diagnosis appendicitis is in laboratory studies. The child takes a blood test, in which the following changes are observed in this disease:

leukocytes with appendicitis in the blood increase their activity, they become more than normal;
increased erythrocyte sedimentation rate;
increased content of bilirubin;
climb C-reactive protein in the first 12 hours.

Urinalysis may show toxic changes:

a small number of leukocytes;
an equally small number of erythrocytes.

Helps diagnose appendicitis in a child Ultrasound that detects the following symptoms diseases:

decrease in the lumen in the appendix (diameter becomes less than 6 mm);
lack of peristalsis;
coprolite;
free fluid in the right iliac fossa or pelvic cavity.

Radiography is not very informative, it can reveal only indirect signs of inflammation and peritonitis.
X-ray (irrigoscopy) is performed if you suspect the presence of chronic appendicitis.
Diagnostic laparoscopy is performed in doubtful cases.
Computed tomography also helps to recognize appendicitis in a child, detecting the expansion of the lumen of the appendix, thickening of its walls, the presence of fluid

Thus, it is possible to check appendicitis in a child only in stationary conditions, sending him to the hospital under the supervision of doctors. Using the wide range diagnostic methods, physicians will exclude other diseases and prescribe surgical intervention if needed. But here the question arises: what should worried parents do while the ambulance is on the way? Is there any way to make it easier pain syndrome characteristic of appendicitis? A few useful tips will help you wait for the doctors in a more relaxed atmosphere.

It is interesting! In many school biology textbooks, the appendix is referred to as a vestigial organ along with the coccyx and ear muscles. It is believed that this internal organ has lost its functions during evolution and is no longer needed by a person.

It is hard for any parent to watch their child suffer from the severe, paroxysmal pain that is usually associated with appendicitis. I want to help him somehow. And here it is very important not to make total mistakes that can only aggravate the condition of the baby. A few helpful tips will help to avoid them and at the same time alleviate the pain syndrome.

You can not warm a sore spot (side, stomach, back, groin): heating pads, infrared lamps, compresses are excluded. It is better to apply ice or a cold heating pad.
It is forbidden to give painkillers and drugs.
Don't give laxatives.
Don't give enemas.
Do not allow to drink and eat. If the baby is very thirsty, give him a small teaspoon of weak iced tea.
You can not walk a lot and make sudden movements. Let the child take a position that is convenient for him: lie on his right side and tuck his legs under him.

These prohibitions should become the desktop rule of all parents. No one is safe from appendicitis, and in most cases it is diagnosed in childhood. In order not to worsen the condition of a sick child, one should not act contrary to these tips. You just need to wait for the ambulance.

Point of view. Not all scientists consider the appendix to be a vestigial, unnecessary organ. In 2007, American doctors from the private Duke University (North Carolina) came to the conclusion that it is necessary for proper digestion.

Treatment

Operation appendectomy - its stages

In acute appendicitis, an emergency (urgent) operation is prescribed in a child, which bears the scientific name - appendectomy (translated as surgical removal of the appendix). Parents are interested in knowing how appendicitis is removed from children: this process is not characterized by anything remarkable. The operation is typical, carried out in exactly the same way as in adults.

Training

Intravenous administration physiological saline. Then - and antibiotics a wide range actions.
If there is no risk of rupture (symptoms less than 24 hours), antibiotic treatment is given for 24 hours to reduce the risk of wound infections.
Antibiotic therapy for children with a perforated appendix is carried out until the symptoms (fever, impaired functioning) are completely eliminated. gastrointestinal tract, increased leukocyte count).

Operation

Rubbing the operated site with alcohol and iodine solution.
Anesthesia.
Opening the cavity.
Finding the process and its removal.
Examination of the abdominal cavity.
Wound closure.
Bandage.

Appendectomy, like all other operations, is performed by a surgeon. At the same time, he is assisted by an operating nurse or a doctor. Currently, the most commonly performed laparoscopic operation is the removal of the process through punctures of the abdominal wall. Its advantages - little risk development of wound infection, shortened hospital stay, a small number of postoperative visits to the doctor, more than fast recovery child's body.

Origin of the word. The term "appendicitis" goes back to the Latin word "appendix", which means a process, with the addition of the suffix -itis, which means "inflammation".

rehabilitation period

The child needs competent rehabilitation after the removal of appendicitis, for which the hospital staff and the attending physician are responsible, and after discharge - the parents. The health of the baby in the future will depend on how quickly the body recovers.

Before discharge

In the postoperative period, the attending physician monitors the child. It includes daily monitoring of the following aspects of his health:

pulse;
the state of the language;
functions of the gastrointestinal tract;
urination;
doctor prescribing enemas, laxatives, dressings.

Terms of termination bed rest determined by the attending physician.

After discharge

Once at home, the child after appendicitis should receive appropriate care, which should be taken care of by the parents. He suggests:

lack of heavy physical exertion, including exemption from physical education and sports;
favorable psychological climate;
treatment of the scar with a weak solution of potassium permanganate within 2 weeks after discharge;
careful monitoring of the seams: whether they have dispersed, whether there is suppuration;
and most importantly - proper nutrition.

The child needs a special diet after appendicitis, which parents should take care of.

First week

fiber-rich: boiled and baked vegetables and fruits, cereals on the water from cereals, puree soups, dried fruits;
lean meat, fish, dairy products, butter;
a lot of liquid (7-11 glasses per day).

First month

Prohibited products:

salted, fried, smoked, spicy dishes;
sauces, mayonnaise;
fatty meats and fish;
soups: fish, okroshka, borscht;
fatty dairy products: milk, cheese, cottage cheese;
fresh bakery;
carbonated drinks;
confectionery (especially cream) products;
potatoes - in limited quantities;
nectarines, pears, grapes - very rare.

light soups and broths on vegetable broth;
boiled and stewed vegetables;
omelets from vegetables and fish;
pasta casseroles;
mushrooms;
lean meat (preferably rabbit meat) and fish (preferably sea);
cereals on diluted milk or water from oatmeal, buckwheat, rice;
skimmed milk, kefir, yogurt;
marshmallows, dried fruits, honey;
oranges, tangerines, raspberries, peaches, strawberries;
green tea, fruit jelly, rosehip decoction.

Nutrition after appendicitis during the rehabilitation period is especially important for the operated child. It will speed up recovery and return to normal life. The risk of developing complications will also depend on this.

From the life of celebrities. The world-famous magician and illusionist Harry Houdini died of appendicitis, as he did not agree to the operation on time.

Complications

If a chronic disease is diagnosed in children extremely rarely and proceeds relatively calmly, then the complications of acute appendicitis can affect the entire future life of the baby. If the operation was not carried out on time, after two days the following processes may begin:

periappendicular infiltrate;
purulent diffuse peritonitis;
periappendicular abscess;
acute pylephlebitis;
appendicular infiltrate;
abscesses of the abdominal cavity and liver;
sepsis;
rupture of the appendix;
phlegmon of the retroperitoneal space;
thrombophlebitis of veins in the pelvic cavity.

Lethal outcome in the absence of surgical intervention during acute appendicitis in children is one of the most terrible and, alas, frequent complications of the disease. Therefore, it is so important to call an ambulance in time at the first suspicion of inflammation of the appendix. And before its development, take all possible preventive measures.

From the Guinness Book of Records. The length of the largest appendix is 23.5 cm with normal sizes 7-8 cm.

Prevention

Prevention of appendicitis in children is complicated by the fact that the main causes of the disease have not yet been precisely established. Namely, they need to try to eliminate. Therefore, parents have no choice but to deal with those factors that supposedly provoke blockage of the appendix. To preventive measures relate:

proper nutrition for the normal activation of the intestinal flora;
timely detection and treatment of any diseases;
lack of contact in young children with small foreign objects that they can swallow;
excretion of helminths from the body;
fight against constipation;
sufficient content of vegetable fiber in the children's diet.

Modern parents are distinguished by high medical literacy and awareness. This reduces the risk of infant mortality due to acute appendicitis. A timely operation eliminates the development of complications and allows children to quickly return to their usual way of life. The most important thing here is to recognize the disease at its initial stage and deliver the patient to the hospital in time. Then it all depends on the doctors. The percentage of medical errors in the diagnosis of pediatric appendicitis is gradually decreasing, so you can be sure of qualified and competent help.

Doctors say that children are increasingly getting sick with appendicitis, and therefore operations in early age is far from uncommon today. Many use erroneous statements like “my appendix hurts”, but in fact it is a diagnosis, and it is made when an inflammatory process is detected in the appendix.

The appendix is a process of the caecum, it is believed that it does not perform any specific function, and therefore the body simply does not need it. Despite this, many people live with this “extra” organ all their lives and do not experience any discomfort, but sometimes they have to deal with its inflammation, which is treated by surgical intervention. The problem can arise for various reasons, one way or another, they are all associated with malnutrition of the process.

Not every child can meet such a diagnosis, so inflammation occurs extremely rarely at the age of 2 years. The most dangerous in terms of the incidence of appendicitis is the age interval from 8 to 12 years. The dynamics of the disease in childhood is more rapid, so it is very important for parents to know all the symptoms of the disease. In case of suspicion, it is necessary to immediately seek medical help in order to have time to avoid dangerous consequences process rupture.

Signs of appendicitis in an acute form in a child

Peak incidence in children usually occurs during periods of change. So, at about the age of three, the transition of the baby to adult food, and at the age of six, upon entering school, getting used to food from the canteen.

Doctor's opinion: some mistakenly believe that only pain can speak of inflammation of the appendix, but in fact, the symptoms are not limited to this manifestation.

Symptoms of the acute form of appendicitis are similar to the manifestations of the disease in adults.

first of all, pain occurs, and initially it is localized in the area near the navel, and after that it shifts to the area of \u200b\u200bthe appendix itself. Older children can easily pinpoint the localization of sensations, with younger children it is more difficult, crying, irritability and sleep problems may indicate pain . Adolescent girls may mistakenly associate their feelings with the menstrual cycle;
strong pain almost always accompanied by the refusal of the child to eat;
often during the acute course of inflammation, vomiting occurs, and in children at a younger age, repeated;
the development of the inflammatory process leads to an increase in body temperature to the level of 39-40 degrees. Often the pulse may not match the level of temperature;
with appendicitis, the patient's tongue remains wet and may become covered with a white coating, if the inflammation proceeds in a gangrenous form, then the tongue must dry out;
often there is constipation, in young children the stool can, on the contrary, become thinner and more frequent, which threatens with dehydration.

The inflammatory process in the child's body proceeds more rapidly, so every minute of delay can adversely affect the baby's condition.

Call an ambulance as soon as possible - this will increase the chances that the appendix will not burst

It is for this reason that babies are often brought to the hospital with a ruptured appendix, which is very dangerous.

Symptoms of chronic appendicitis

Unlike the acute form, appendicitis in chronic course occurs much less frequently. In this case, the inflammation proceeds sluggishly, and the clinical picture is less bright. Often this problem occurs as a result of the transferred acute form without surgical intervention.

There are several varieties of the disease in a chronic form and they differ in the nature of their manifestations:

the residual type is diagnosed when the patient has suffered an acute form without surgery. In this case, the symptoms subside, but everything remains in the process. the necessary conditions for the development of inflammation;
the relapsing type is characterized constant change periods of exacerbation of symptoms and remission;
the latter type is described only by a part of the authors and is called the primary. In this case, the symptoms of the disease increase gradually, no acute attacks are observed, and the development of the chronic form is not preceded by an acute course of the disease.

The first manifestations that should alert parents are dull pain in the region of the anterior lateral abdominal wall, especially if they occur after physical exertion or sudden movements of the child. Often there is a feeling of heaviness, diarrhea and nausea. As for the temperature, it usually does not rise, but jumps can sometimes be observed closer to the night. In most cases, parents go to the hospital to provoke stabbing pains in the abdomen of the child, which recur periodically.

Doctor's note: it is worth noting that the concepts of "exacerbation of the chronic form of appendix inflammation" and "acute appendicitis" are identical to each other, since in such situations both the processes occurring in the organ and the symptomatic manifestations are completely the same.

The specificity of the chronic form of the disease is also that the attacks are mostly short-lived, often upon the arrival of doctors there are only residual symptoms - pain on palpation.

The child is not always able to accurately explain his feelings, so great importance has an inspection

It is very difficult to accurately diagnose "chronic appendicitis" with such symptoms, since it is necessary to differentiate it from a number of other diseases of the gastrointestinal tract. It will be possible to clearly indicate the problem only after a general examination of the child.

Difficulties in determining appendicitis in a child

Despite the rarity of such cases, appendicitis can also occur in a very young child. Although the symptoms at a young age are no different from the manifestations of the disease in older children or adults, there may be some difficulties with the explanation on the part of the baby.

The inflammatory process in the terminal part of the caecum is called appendicitis. This disease occurs in people of all ages. They can easily affect young children and teenagers. Without timely medical attention, this disease can be deadly or cause serious complications.

Causes and provoking factors

The causes of appendicitis can be completely different external factors. As a rule, inflammation occurs after hypothermia or a decrease in immunity. A child can also get this disease if he has chronic diseases digestive system.

Improper nutrition low-quality products can also easily cause an inflammatory process in the intestines. The intake of a large amount of crude fiber can provoke acute inflammation of the terminal part of the caecum, causing disease.

Most a rare cause the occurrence of appendicitis may be congenital pathologies of the intestine. In this case, the baby is already born with a modified intestine. This may be an individual shortening of the length, as well as multiple bends or kinks in the wall. In this case, it is also quite common when exposed to external factors appendicitis may develop.

Why is it important timely diagnosis appendicitis can be seen in the next video.

Kinds

Like any inflammatory disease, appendicitis can occur in several forms. If the disease arose for the first time and proceeds with sufficiently pronounced clinical symptoms, then this form is called acute. If, after the treatment, in which the appendix was not removed, appendicitis occurs again, then this form of the disease is called chronic. It requires the removal of the appendix in order to prevent future dangerous symptoms.

All acute forms of the disease can be divided into several types:

catarrhal form of the disease. In this case, the disease proceeds as calmly as possible and, as a rule, does not cause life-threatening complications. With this form, the inflammatory process captures the wall of the caecum and provokes the appearance of the first specific symptoms appendicitis. If a surgical operation was performed on time, the baby is completely cured.
Phlegmonous form of the disease. Is already more dangerous, it can cause life-threatening complications. With this variant of the course of the disease, severe inflammation of the intestinal wall already occurs. Thrombosis of the vessels supplying the caecum is also possible.
Gangrenous form. The most dangerous variant of the course of the disease. During inflammation in this course of the disease, the intestinal wall dies off. This option can cause life-threatening complications for the child: a breakthrough of the wall and the release of the entire contents of the intestine into the stomach (with the formation of peritonitis and shock). In this case, an urgent surgical operation with removal of the organ is required. Only this measure will help save the baby's life.

First signs

It is better for each mother to be familiar with the manifestations of this disease in order to easily recognize dangerous problem at home. Defining this disease is not always easy.

Often parents think that the appendix is on the right side. However, this is not quite true. The appendix is very mobile. Anatomically, it can be located not only on the right. In 20% of babies, it is on the left side. In every 9 out of 10 children, it can even be located near the navel.

The onset of the disease can be quite non-specific. In many babies, the onset of the disease proceeds under the guise of a common cold. In the first days, the body temperature rises to 37 degrees, weakness appears, less often chills. The child becomes lethargic, eats poorly, refuses to play. Habitual activities do not bring him any joy. The baby is drowsy, often lies, spares the tummy.

During the first two days, parents often cannot suspect appendicitis and begin to give the child drugs for fever, as with the flu or acute respiratory infections. However, despite the started treatment, the effect is not noticed. In the meantime, the child is getting worse. There are already more specific symptoms for this disease. Body temperature rises to 38-39 degrees. The child complains of abdominal pain.

In the first two days, the pain begins in the area near the navel. Then it gradually descends down to the groin or into right half body. The pain increases significantly with a change in body position. The child may experience nausea or even vomiting. However, these are not mandatory symptoms characteristic of appendicitis.

It is important to note the nature of pain in appendicitis. It may be different. Some babies feel pain moderately, without sharp gains. Others are spasms. In this case, the pain first intensifies, then subsides a little. As a rule, in most cases, stool disorders do not occur. Only in babies with chronic diseases of the intestines or stomach, constipation or diarrhea can sometimes occur, but these are non-specific signs of the disease.

Does it show up the same way?

In children of different ages, the course of the disease can vary significantly. According to the latest scientific research the peak incidence occurs at the age of 10 years, 12 years. In most cases, babies are not affected at all. this disease. Babies under 5 years of age also get sick relatively rarely.

According to statistical medical data, every fifth person with appendicitis is a child aged 6 or 7 years. More than half of all cases of inflammation of the appendix in children occur in the younger and middle school age. As a rule, these are children from seven to 14 years.

Since the body of a three-year-old baby is noticeably different, for example, from the body of a nine-year-old schoolboy, the course of the disease is also different.

Up to five years

For babies of this age, the gradual development of the disease is characteristic. Body temperature rises relatively low. Quite often, nausea or vomiting may occur. Children often become capricious, eat poorly, and are very restless.

Babies under three years of age often have thirst and all the symptoms of dehydration. Skin and lips become dry. The baby begins to spare the tummy, does not allow to examine or touch. Babies in the first two years of life can also often develop constipation or very loose, single stools.

Up to ten years

In children, body temperature rises to 37.5-38 degrees. In more severe variants of the disease - even up to 39 degrees. Toddlers often feel sick, while vomiting or stool disorders, as a rule, do not occur.

Characterized by severe pain in the abdomen. When viewed or trying to touch the tummy, it increases significantly. The child tries not to lie down on the damaged side, as this greatly increases the pain.

Teenagers over 12 years old

In many cases, appendicitis at this age follows almost the same scenarios as in adults. In the first couple of days, characteristic pains appear in the umbilical region with a gradual movement to the right half of the abdomen or groin. Often the body temperature rises to 37-37.5 degrees. The pain is often paroxysmal, without severe spasms.

Stool disturbances, nausea or vomiting are not typical. But quite often there are signs of dehydration. The child has reduced or practically no appetite, weakness appears.

All symptoms of the disease are nonspecific. Often it is quite difficult to determine appendicitis on your own. In this case, you should definitely seek professional medical advice from a pediatrician.

Diagnostics

The appearance of the first symptoms of the disease is not yet a 100% method of making a diagnosis. Only a doctor can confirm appendicitis. To do this, the doctor will first examine the baby, conduct all the special medical tests that allow you to confirm the disease with sufficient accuracy already at home.

To make an accurate diagnosis, you need to take the child to the hospital. Without fail, he will do several tests. Clinical Analysis blood will show whether there is inflammation, as well as the severity of the development of the disease.

In difficult cases, when the diagnosis of appendicitis is difficult to establish, doctors resort to additional methods diagnostics. First, the surgeon will look at the baby. Then the child may have an ultrasound examination of the abdominal organs. This test will show what condition the appendix is in, whether there is inflammation.

Before performing surgery to remove the appendix, doctors will take blood from the baby for additional tests. This is necessary for future anesthesia and surgery.

Treatment Methods

Inflammation of the appendix is a surgical disease. In most cases, when the diagnosis is confirmed, the inflamed organ must be surgically removed. Home mode in this case is extremely dangerous. Without the provision of timely qualified medical care, the baby may even die.

During your stay in the hospital, your baby will have all the necessary urgent diagnostic tests and tests. After confirming the diagnosis, an operation to remove the appendix will be performed in a fairly short time. Postponing the operation in many cases is very dangerous. This can lead to the development of peritonitis or septic shock in the baby.

Recovery after the operation usually lasts 10-14 days. At this time, the baby is assigned special diet sparing the organs of the gastrointestinal tract. Vitamin therapy will help to quickly restore the child's immunity. All physical exercise(and even more so visiting sports sections) are allowed a month after the operation, not earlier. In this case, all physical activity should be introduced gradually. Lifting heavy objects over 5 kg is strictly prohibited (for three months).

Possible Complications

The most common complications of appendicitis include:

development of peritonitis. If medical care was not provided in time or the disease proceeds in an aggressive and dangerous form, inflammation of the peritoneum may occur. This significantly worsens the prognosis and requires urgent surgery.
Septic shock. In some cases, appendicitis can also be caused by bacteria or viruses. With reduced immunity, the child may develop shock. In this case, blood pressure drops sharply and the pulse quickens. The baby may even lose consciousness. The development of shock is a life-threatening event.
Breakthrough of the wall of the caecum. If the disease is suspected late (or a surgical operation is not done in time), due to severe inflammation, the intestinal contents can pour into the abdominal cavity. This is a very dangerous condition that can cause peritonitis or septic shock in minutes.
Shock (due to dehydration). With severe symptoms of intoxication appear severe symptoms dehydration. This leads to a large load on the heart and blood vessels. The baby may develop tachycardia or arrhythmia.

Complications of appendicitis can occur in almost any course of the disease. If the baby has chronic diseases, immunity is reduced, or he receives corticosteroid hormones, the risk of developing complications increases several times.

Nutrition principles

After surgery to remove the appendix while still in the hospital, the baby will be prescribed a special sparing diet. For the first few days, babies are allowed to eat only mashed and low-fat foods. All dishes are prepared in a gentle way. As a rule, the menu contains only cereals, grated slimy soups and steamed lean meat.

When discharged from the hospital, the attending surgeon gives recommendations to the mother about what the baby can eat after the operation. A therapeutic diet is recommended to be followed for one to two months. This will allow the inflamed intestinal wall to recover quickly, weak children's body strengthened.

Basic principles of therapeutic nutrition after surgery:

Small portions of food. Babies should eat up to six times a day (in moderation). The volume and quantity of food is measured according to age tables. Overeating in the postoperative period is very dangerous! This can lead to re-inflammation of the intestines and provoke the appearance of complications.
No very fatty, fried foods. All products containing smoked products or marinades are also excluded. All food should only be lightly salted. Spicy and overly bright seasonings are prohibited. In the first month, only a little table salt can be added to food. From the fifth week after the operation, you can add a little black pepper. Sugar, vanilla or a little cinnamon can be added to sweet dishes.
During the first two weeks after the operation, fresh fruits and vegetables can only be eaten after heat treatment. Raw fruits with peel are strictly prohibited. Apples and pears are delicious after roasting with a little cinnamon or powdered sugar. Try to limit the high amount of crude fiber in your child's diet.
Introduce fiber gradually. The basis of the diet in the first two weeks for the baby is well-boiled cereals, as well as meat products or a bird. You can use fish.
Choose a gentle way of cooking. Leave roasting and grilling until full recovery baby. The most correct cooking methods would be boiling or cooking in a slow cooker, double boiler.
As the right carbohydrates, use well-boiled cereals. No more than 1-2 times a week, you can add a little pasta or noodles. In the first two weeks after surgery, prepare dairy-free cereals. The addition of dairy products can lead to a violation of the stool, to the appearance of diarrhea.
Sufficient water intake. After severe dehydration, the child's body really needs water (to replenish lost reserves). Add fruit and berry fruit drinks, compotes, tea and plain boiled water to your child's diet.

Prevention

It is almost impossible to insure against the appearance of appendicitis. At any age, this disease can be taken by surprise. However, when executing following conditions You can slightly reduce the likelihood of appendicitis in your child:

Treatment of appendicitis should be timely and fast. Delay in providing medical care for this disease is unacceptable! Only an emergency surgical operation will help to cure the disease in time and save the life of your baby. You can suspect the disease yourself, but call an ambulance or pediatrician should definitely.

What may indicate abdominal pain in a child, see the following video.

Appendicitis in medicine is called the inflammatory process of the appendix. The disease belongs to dangerous pathologies, since it is difficult to diagnose, and with untimely treatment, dangerous complications develop. Signs of appendicitis in children differ from the symptoms of the disease in adults.

Inflammation of the appendix can occur in children of all ages. The symptomatology of the pathology is similar to the signs of many diseases of the gastrointestinal tract, including infectious ones. Therefore, diagnosing the disease is difficult even for experienced doctors.

In addition, the symptoms of the disease in children depend on their age. For example, in infants, diarrhea is a sign, and in adolescents, on the contrary, constipation often occurs.

A feature of appendicitis in children is its rapid development. If the signs of the disease are ignored, dangerous complications may occur.

The first signs of appendicitis

The first symptom of the pathology is acute pain in the navel area.

Which part of the abdomen it moves to depends on the location of the appendix:

usual placement of the appendix - pain in the lower right side;
subhepatic location - soreness in the hypochondrium on the right;
pelvic location - the suprapubic part of the abdomen hurts, the child often urinates, diarrhea with mucus may occur;
retrocyclic localization (behind the rectum) - lumbar pain.

The classic manifestation of appendicitis is pain in the umbilical region, which goes down the right side of the abdomen. Near the navel it is usually dull and aching, and after moving down it becomes intense, sharp and stabbing.

With atypical locations of the process, other symptoms may occur (discomfort and pain in the inguinal zone, urinary problems, tense abdomen). In such cases, a dangerous complication is the gangrenous form of inflammation of the appendix.

Signs of inflammation of the appendix in children are also considered:

refusal to eat;
difficulty walking;
white coating on the tongue;
sharp pain in the abdomen when jumping, coughing, riding.

Regarding the temperature, it rises to different levels depending on age. The highest is with appendicitis in children, subfebrile (not higher than 38 degrees) - in adolescence. There are no symptoms observed respiratory diseases: cough, nasal congestion, runny nose, pain and redness in the throat.

A child with appendicitis may feel sick, often vomiting begins, which does not bring relief. Sometimes pathology, along with the above signs, can manifest itself liquid stool and constipation.

Another sign of appendicitis: if you put the child in a supine position with legs bent at the knees, then with gentle pressure on the right side, the pain subsides. If you suddenly release your fingers, then there is an increase in soreness.

If such symptoms are observed, then it is better to show the child to the doctor.

How to recognize a seizure in children under 3 years old?

In babies, it is especially difficult to determine the pathology, because they are not able to express their feelings. Appendicitis at this age is the most dangerous because of the sudden onset and rapid development. However, due to anatomical features intestines and proper nutrition in young children, the appendix becomes inflamed extremely rarely.

Usually at this age, with appendicitis, the child is very restless: he presses his legs to his stomach, tries to lie on his left side, curled up. On palpation of the abdomen, children usually cry.

Signs of inflammation of the appendix at this age include:

capriciousness;
refusal to eat;
pulling the legs to the stomach;
anxiety;
cry;
frequent regurgitation;
sleep disturbance;
vomiting (usually multiple);
nausea;
pain when urinating;
rapid pulse;
reduced activity;
pallor of the skin;
hyperthermia - up to 40 degrees;
dryness in the mouth;
pallor of the tongue;
loose stools with mucous secretions;
general weakness.

In some cases, a child under the age of three has diarrhea or constipation. It is also important to note that children who are fed breast milk, usually the temperature rises no higher than 37.5 degrees.

Signs of appendicitis in children 5 years old

Preschool children may not talk about abdominal discomfort for a long time because they do not pay attention to mild pain.

Symptoms of appendicitis in children 3 to 5 years of age include:

The temperature in children of this age with appendicitis rises to 38.5-39 degrees.

Symptoms of pathology in a child of school age

In schoolchildren, appendicitis manifests itself with the same signs as in adult patients.

To typical features pathological condition relate:

vomiting (may be double or single);
elevated subfebrile temperature (up to 38 degrees);
loss of appetite;
disturbed sleep;
increased pain when bending forward;
dry tongue and white coating on it;
pain in the lower abdomen.

Usually observed normal stool. However, sometimes constipation or diarrhea occurs.

Experts say that most often at this age, with an inflamed appendix, atypical symptoms develop:

soreness in the back;
discomfort in the epigastric zone;
pain in the rectum.

The location of the pain depends primarily on the location of the appendix.

Signs of appendicitis in teenagers

Inflammation of the process, according to statistics, they occur more often than in young children.

One of the symptoms of the disease in adolescence is the syndrome of "toxic scissors". In this case, there is a discrepancy between the rapid pulse and body temperature.

Symptoms of appendicitis in children from 12 to 17 years old are:

abdominal pain (localization depends on the location of the appendix);
temperature rise;
single vomiting;
constipation;
weakness;
plaque on the tongue.

Treatment of appendicitis in children

Appendicitis treated surgically- perform an appendectomy. For this purpose, two methods of surgical intervention are used:

removal of the appendix in an open way (through an incision in the abdominal cavity);
laparoscopy (use of a special surgical instrument).

The operation is carried out under general anesthesia. It lasts from half an hour to sixty minutes.

After surgery, in order to prevent the development of complications, the child is prescribed antibacterial drugs.

The wound after incisions and laparoscopy until healing is treated daily with antiseptic solutions and a sterile bandage is applied to it.

In addition, after the operation, it is necessary to comply diet food. Immediately after surgery, you can give your child some water to drink, starting with a drop and increasing to a teaspoon.

The next day, low-fat kefir or weak broth is allowed.

Possible Complications

If you ignore the signs of pathology in children, then life-threatening complications can quickly develop. simple form the disease rapidly develops into destructive appendicitis (gangrenous and phlegmonous).

Serious consequences of appendicitis are:

appendicular peritonitis;
intestinal obstruction;
internal bleeding;
perforation of the wall of the appendix;
abscess appendicular;
sepsis.

These consequences may end lethal outcome if they are not diagnosed and treated in time. Sometimes a periappendicular infiltrate develops, which passes into chronic form. With timely access to a doctor and treatment, the risk of developing these complications is reduced several times. In this case, the prognosis is favorable.

Frequent diarrhea and vomiting with appendicitis in a child can result in dehydration.

To postoperative complications include the appearance of pus at the seams, problems with the abdominal organs, subdiaphragmatic abscess.

Thus, appendicitis in children of different ages can manifest itself in different ways. Symptoms of pathology are similar to other diseases and poisoning. Inflammation of the appendix in childhood has its own characteristics and is fraught with a rapid onset severe complications. Therefore, when signs of inflammation of the process appear, you should not hesitate, but call emergency help.