Appendicitis – inflammatory disease, occurring in the abdominal part of the body, usually requires surgery. Cases have been identified where the disease led to death (statistically, 0.1% of patients die from the acute stage).
The word “appendix” can be deciphered as “a worm-like appendage”, it is located with right side abdominal cavity. It is this inflammation that is commonly called appendicitis. This disease develops when the space between the appendix and the intestine becomes clogged.
information The hardest thing this inflammation carried by children. Most often, appendicitis occurs at the age of 7-10 years, but the disease can manifest itself even in a child of the first year of life.
Classification
It is customary to divide appendicitis into simple And complicated. Usually, appendix is located in the right iliac region, but it can also be located on the left, as well as in the retrocecal, subhepatic and pelvic space.
According to studies done in recent years, it can be said that appendicitis in a child can develop as spicy, so chronic.
Causes of appendicitis in children
Appendicitis is a condition that develops as a result of counteraction normal operation vermiform appendix and subsequent bacterial invasion.
This also includes some anomalies: bends or torsions of the intestine.
Reducing the intestinal lumen and hyperproduction of mucus increases the pressure in it, which can lead to swelling of the appendix mucosa and increase tension in its walls. As a result, the outflow of blood from the appendix slows down, which contributes to the rapid proliferation of bacteria.
dangerous Already after 12 hours in inflammatory process The peritoneum may also be involved. Violated arterial blood supply appendix and tissue ischemia occurs, as well as necrosis of the appendix wall. In the most advanced cases, perforation of the wall is possible with access to abdominal cavity purulent and fecal contents.
It usually takes 24-36 hours for appendicitis to fully develop.
Children under two years of age extremely rarely suffer from acute appendicitis, this is due to their special diet and the location of the appendix. The disease can appear only if the lymphatic follicles in that same process are poorly developed.
Your own intestinal microflora is very important and appendix in children, since the development of appendicitis is often associated with diseases, sinusitis, and others. Diseases such as typhoid fever can independently provoke the development of appendicitis.
Appendicitis can also be caused by:
- binge eating;
- insufficient level of fiber in the diet;
- food with increased content Sahara;
- constipation, gastroenteritis, etc.
Symptoms
Appendicitis cannot be recognized the first time in every case, because such a disease can masquerade as other ailments. Its location is also specific; it is not always located in the same place; sometimes it is found in other parts of the abdominal cavity. Statistics show that only 30% correspond to a typical disease, the remaining 70% require a different approach.
Appendicitis in children may be different symptoms. If the location of appendicitis is atypical, then the symptoms of the disease may include:
- pain in the back, rectum;
- in pelvic position: frequent urination with pain in the abdominal part of the body;
- if the appendix has a subhepatic location, then pain may occur in the stomach, and then descend into right side belly.
Symptoms in children under 3 years of age
It is quite difficult to recognize the disease in a child under three years of age, because it is often not in any certain place, but it seems to “spill” all over the stomach. In this case, you need to pay attention to the baby’s behavior:
- he will become too whiny;
- will not eat;
- prohibits touching the tummy.
information Parents may also notice vomiting and appendicitis will be accompanied elevated temperature(up to 40° C) and sharp deterioration baby's well-being. The mucous membranes of the mouth and tongue become dry, the body becomes dehydrated.
Symptoms in children 3-7 years old
- The child may complain of pain in the navel area. It will be unobtrusive but constant, and will gradually move to the right iliac abdomen.
- The baby may vomit, but usually no more than once.
- Body temperature remains normal; if an increase is noticed, it is only up to 37.5° C.
If development occurs purulent appendicitis, then the child’s condition rapidly deteriorates: the skin turns pale, the child feels thirsty, and constantly licks dry lips.
If the disease accompanied by another disease(for example, measles), appendicitis can manifest itself in the form of nausea, vomiting, diarrhea.
Diagnosis of appendicitis
In order to identify the disease, you can undergo a number of procedures:
- . When the disease appears, the number of white cells in the blood increases; they can appear already at the initial stage, but it must be remembered that the increased presence of these cells can be an indicator of any other inflammatory disease.
- X-ray of the abdomen. Through such a study, it is possible to identify a coprolite (a small piece of feces that has blocked the exit from the appendix), which is often the cause of appendicitis.
- Ultrasound. Unfortunately, it can indicate appendicitis only in half of the cases, since ultrasonography can reveal other diseases that are close to the appendix. To know for sure that an ultrasound shows appendicitis, you need to be sure that there cannot be other diseases.
- CT scan. Helps confirm the diagnosis of appendicitis in most cases.
- Laparoscopy. Helps to identify the disease for sure. A tube is passed through a small hole in the abdomen, through which the doctor can see the appendix and other organs. If the disease is confirmed, appendicitis can be removed immediately.
Treatment of appendicitis in children
important Appendicitis in children requires mandatory treatment surgically. If pain occurs, you can take no-shpa, and then call a doctor. It is forbidden to use painkillers, it is also forbidden to use heating pads and warming compresses! At acute pain call emergency help.
In the hospital, you will first have to undergo a series of procedures to identify the disease. If the diagnosis is confirmed, the child will be sent to surgery department. If there is no doubt that the baby has appendicitis, an operation is performed (it is performed under general anesthesia).
- After operation appointed bed rest. It is forbidden to eat food.
- Only on the second day After the operation, you can start walking, but only if the doctor gives permission. A diet is prescribed, so in the first days you only need to eat oatmeal, low-fat cottage cheese and baby food.
- Only on the third day You are allowed to eat boiled chicken and soup with low-fat broth.
- A week later diet, you can switch to a normal diet.
- The stitches are removed after 7-8 days.
- Heavy loads should be avoided, but light loads can be taken up after 1.5-3 months. Otherwise, a hernia may form at the site of the suture due to the fact that the damaged muscles have not yet had time to restore their integrity.
Appendicitis is an inflammation of the appendix, or cecum (the vermiform appendage of the large intestine). Most often, the process is located at the junction small intestine in thick. But the appendix can be located in the subhepatic space, in the small pelvis, and behind the ascending colon. Moreover, the process is not always located in the right lower section abdomen - it can be 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.
Causes of appendicitis
Factors predisposing to appendicitis are constipation, dysbacteriosis and helminthic infestations, as well as abuse of sweets.Since the functions of the appendix are not fully understood, there are presumably several reasons for its inflammation. It is believed that inflammation of the appendix develops due to blockage of the appendix lumen and exposure to microflora. It can cause obstruction (blockage) fecal stones, foreign body that has entered the intestinal lumen.
The lumen of the appendix and its connection with the intestine can also be blocked by excessive growth of the lymphoid follicles that form it. It may also matter congenital anomaly(bends) of the process. Microorganisms from the intestine remain in the lumen of the appendix.
Microbes can also be carried there with blood or lymph, because appendicitis often develops after suffering from otitis media, acute respiratory infections and other diseases. Some infections (yersiniosis, typhoid fever, etc.) cause inflammation of the appendix.
Bacteria in the lumen of the appendix multiply and cause inflammation; mucus secretion increases, swelling develops and venous stasis in the intestinal wall. In the future, this can lead to the development of necrosis (death) of the appendix, rupture of its wall and the entry of intestinal contents (pus and feces) into the abdominal cavity - develops.
Predisposing factors for the development of appendicitis in children may be helminthic infestations, overeating, abuse of sweets, and insufficient dietary fiber.
Until a child is 2 years of age, appendicitis rarely develops (although it can also occur in a newborn). This is explained by the nature of the child’s nutrition and the insufficient development of lymphoid follicles in the appendage itself. Due to this underdevelopment, the appendix communicates with the intestines through a wide opening that is difficult to block. And by the age of 6 lymphoid tissue matures, and the incidence of appendicitis increases.
Classification of appendicitis in children
There are acute and chronic appendicitis.
Types of acute appendicitis:
- Appendiceal colic: mild inflammation of the appendix, which resolves 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 appendix is covered with purulent plaque, with ulceration of the mucous membrane and accumulation of pus in its cavity; with purulent or cloudy effusion into the abdominal cavity.
- Gangrenous appendicitis (with or without perforation) develops as a result of thrombosis of the vessels of the appendix: a dirty green appendix with foul odor and effusion; accompanied by severe general condition child.
- Complicated appendicitis.
Symptoms of appendicitis in children
Manifestations of appendicitis in children are very diverse and depend on age, location of the appendix itself and the stage of its inflammation.
A small child becomes lethargic, is not interested in toys, and refuses to eat. The very first sign of appendicitis is pain. The baby is trying to protect sore spot: often lies on his left side, draws in his legs, kicks his legs, cries when picked up, resists examination of the abdomen (pushes the hand away).
The child's temperature rises to 38˚C, and sometimes higher. The child is pale, the heart rate is rapid, vomiting appears and loose stool. The younger the child is, the more frequent the vomiting; Dehydration can develop quite quickly small child, manifested by pronounced 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 cannot always clearly show the place where exactly their abdominal pain is localized. Most often they point the pen at the navel area or point at the entire abdomen.
Children do not necessarily show all the symptoms listed above. The process of inflammation of the appendix can worsen rapidly, and within a few hours peritonitis can develop. The pain spreads to the entire abdomen, the child is pale, the temperature rises to 40˚C, the abdomen is distended, and stool retention may occur.
The danger is also that many parents believe that appendicitis does not happen at this age, and attribute these manifestations to overeating, poisoning and other reasons. And some even begin to treat the baby themselves. Without surgical treatment, the appendix may burst (this occurs in 25-50% of children), which leads to complications, long-term treatment in the hospital.
From 6-7 years of age, a child is able to indicate the location of abdominal pain. In the classic version of the development of the process, the pain is first localized in the epigastric region or periumbilical region, and then (after 2-3 hours) it descends to the right iliac region (projection of the location of the process). With a subhepatic location, its pain shifts to the right hypochondrium, with a location behind the cecum - pain in the lower back, with a pelvic location - pain is noted in the suprapubic region.
The nature of the pain with appendicitis is constant, without contractions, the pain is not sharply expressed. Constant pain leads to sleep disturbance. Pain does not cause the child to thrash around. The child refuses to eat. Very often, vomiting occurs once or twice. Possible stool retention.
The temperature is elevated within 37.5 C; sometimes rises to high numbers, but may remain normal. For older age group In children, a discrepancy between pulse and temperature is typical. Typically, when the temperature rises by 1 degree, the pulse increases by 10 beats. And with appendicitis, the pulse significantly exceeds the increase in temperature.
With the pelvic location of the appendix, frequent urination is noted. With catarrhal appendicitis, the tongue is wet and coated at the root with a white coating; with phlegmonous - it is also moist, but completely covered; with gangrenous - the tongue is dry and completely coated.
Age high risk According to the development of inflammation of the appendix, the age from 9 to 12 years is 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 diagnose children than adults. At this age, the child can continue to attend school, although his stomach hurts. But the process continues to develop, and the child’s condition can deteriorate sharply already at the stage of complicated appendicitis.
Chronic appendicitis in childhood occurs less frequently than in adult patients. It is characterized by the appearance of recurrent attacks of pain in the area of the projection of the location of the process, with an increase in temperature and nausea.
Complications of appendicitis
To avoid complications, it is necessary to carry out timely surgical treatment. If this has not been done, then it may occur whole line complications:
- perforation (breakthrough) of the appendix with subsequent development of peritonitis (inflammation of the peritoneum);
- appendiceal infiltrate (limited peritonitis, may contribute to the formation of a conglomerate of intestinal loops, omentum and peritoneum);
- appendiceal abscess (abscess in the abdominal cavity) in the area where the inflamed appendix is located or at some distance from it;
- intestinal obstruction;
- sepsis (a generalized disease due to microorganisms from the inflamed appendix entering the blood and being carried into the various organs with the formation of ulcers).
Diagnosis of appendicitis in children
When palpating the abdomen, the doctor will detect pain in the right iliac region, and will also check objective symptoms characteristic of appendicitis, some of which will certainly be positive. Various methods are used to diagnose appendicitis:
- examination of the child with palpation of the abdomen; digital rectal examination;
- laboratory examination ( clinical tests blood and), if necessary - bacteriological analysis of stool, coprogram;
- instrumental methods: ultrasound of the abdominal cavity and pelvis, electromyography; in difficult to diagnose cases, specialists can use x-ray examination or computed tomography abdominal organs (CT), diagnostic laparoscopy(operation through three punctures in the abdominal cavity with the introduction of a telescopic video camera);
- consultation pediatric gynecologist(for girls of childbearing age).
When examining and palpating (feeling) the abdomen, the doctor identifies local or diffuse pain, lag in 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 diagnose or rule out appendicitis on their own: in order to evaluate the symptoms mentioned, you need to have experience in identifying and comparing them. In young patients, symptoms may sometimes need to be checked during sleep. With a digital rectal examination, the doctor identifies pain and sagging of the anterior wall of the rectum and excludes other diseases.
A blood test can reveal an increase in the number of leukocytes in appendicitis, an increase in the number of neutrophil leukocytes. In a urine test, red blood cells, white blood cells, and protein may 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 identify the presence of fluid in the abdominal cavity, infiltrates and abscesses.
Sometimes diagnostics requires dynamic observation for a child by a surgeon for 6-12 hours in a hospital setting.
Treatment
Basic rules for parents:
- If you experience abdominal pain, you should not use any painkillers (including no-spa) yourself - these drugs can make it difficult to diagnose the disease.
- You should not give your child an enema or a laxative.
- You should also not use a heating pad on your 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 liquid to drink: if the diagnosis is confirmed, the operation will be performed under anesthesia, and 3 hours before the operation the consumption of food and liquid is excluded; if you are very thirsty, you can simply wet your child’s lips.
- 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 - absolute readings for surgery. The operation can be performed in an open traditional or laparoscopic manner. Both operational methods are performed under general anesthesia.
The operation lasts 30-60 minutes. The prognosis for timely surgery is favorable. After the operation, the child cannot drink liquids, but can only wet their lips. Only the surgeon allows food intake and determines the nature of this food. In uncomplicated cases, the child is usually discharged after 5-8 days.
Preferably laparoscopic method operation, 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 case of complicated appendicitis, the operation is performed in an open manner.
In case of a destructive form of appendicitis, preparation is carried out for 2-4 hours before the operation: prescribed infusion therapy (intravenous administration liquids 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 monitored so that if the temperature rises or other symptoms appear, contact a doctor immediately.
According to available statistics, every year many people (about 1 million people) have to deal with such a problem as appendicitis. It is important to note that most Patients with this diagnosis include young children and adolescents. Currently, mortality due to appendicitis is negligible.
The appendix is a small appendage (no more than 10 cm), which is located at the end of the so-called cecum. Outwardly, it resembles a worm and does not play a special role in the digestion process. This was believed several decades ago. Previously, experts considered the appendix to be a useless appendage in the body and were removed during any related operations. Today doctors have a different opinion and, in the absence of an inflammatory process, try not to remove it. The thing is that special protective cells were found in this process. In addition, it produces intestinal juice. It becomes clear that the appendix still plays some role in the process of digestion and protection of the body, although it is insignificant. In this article we will talk in more detail about what this disease is, how to identify appendicitis in a child, and how this problem can be eliminated.
general information
Appendicitis is usually understood as inflammation of the appendix directly to the cecum itself, which always requires surgical intervention. Today, doctors identify several reasons leading to the development of this problem. Note that without proper treatment it is almost impossible to solve it.
Many people today believe that appendicitis cannot occur in a child. This statement is completely wrong. After the first year of life, the risk of developing this problem constantly increases. The peak of the disease, according to experts, occurs between the ages of 9 and approximately 12 years. As already noted above, the only way The treatment for this disease is surgery surgical intervention.
If the diagnosis was made in a timely manner, and doctors took everything to eliminate it necessary measures, then in in this case appendicitis is not scary. Optimal time for surgery from the onset of the attack is 6-18 hours. So, if for some reason this period of time was missed, the tissues in the appendix begin to gradually loosen. Then the pus pours directly into the abdominal cavity, which already entails more serious inflammation, namely peritonitis.
According to experts, this disease is practically not diagnosed in infants. However, from about three years of age, the risk of developing the disease increases several times, and about 80% of all cases occur at the age of 9-10 years.
The signs of appendicitis in children are similar to the symptoms of this disease in adults, but there are still significant differences, which are explained anatomical features young body.
Main reasons
Currently, experts put forward several assumptions that explain the mechanism of development of the inflammatory process in the appendix.
Listed above are only the main causes of appendicitis in children. In fact, experts today also name other factors contributing to the development of this problem. For example, frequent stressful situations. There is an opinion that swipe in the stomach can also provoke this disease. In this case, there is a rapid narrowing blood vessels, which entails severe inflammation of the appendix.
Clinical forms of the disease
According to experts, signs of appendicitis in children primarily depend on clinical form illness. The inflammatory process can be of the following types:
- simple (uncomplicated) appendicitis;
- gangrenous appendicitis;
- phlegmous variant of the disease;
- complicated perforated appendicitis;
Symptoms of the disease in children under five years of age
- Moody and restlessness.
- Loose and frequent stools.
- Lack of appetite.
- Painful urination (the child constantly cries).
- Drowsiness and lethargy.
- Vomit.
- Temperature rises to 40 degrees.
- Pale skin.
It can be quite difficult to confirm appendicitis in a 3-year-old child only by external clinical signs. The thing is that at this age the pain is not localized in any specific place. That is why it is so important to regularly monitor the baby’s condition, and if the above-described signs appear, immediately seek help. qualified help.
Symptoms of the disease in children from 5 to 15 years old
Appendicitis in a 10-year-old child primarily manifests itself as pain in the abdominal area. At the beginning of the disease, when discomfort is not clearly expressed, the child can go to school, play with other children and be active. Then the condition worsens sharply. Within just a few hours, the child becomes drowsy, his body temperature quickly rises, and he refuses to eat. About six hours after discomfort begins, typical signs of appendicitis in children appear. This includes nausea, a yellowish coating on the tongue, upset stool, and severe pain in the navel area.
It also happens that a child literally suddenly falls ill. For example, in the morning he may wake up with severe pain on the right side of the abdomen and fever. When you press on this area, the child may even scream. All these symptoms can be considered a reason to suspect the presence of acute appendicitis. Note that in modern medicine There are two variants of the course of the disease: acute and chronic. The latter is characterized by some atrophic changes in the very wall of the appendix.
Acute appendicitis in children is dangerous because it literally “masks” itself as other diseases, significantly complicating the final diagnosis. This is due to the fact that the vermiform appendix is often located in an atypical place (in the area Bladder or near the liver). As a result, the clinical picture completely changes.
How to determine appendicitis in a child yourself?
Parents can identify the disease on their own, however, this does not mean that they should not seek qualified help.
The first thing you can do is ask your child to cough. If at the same time he feels discomfort in the right iliac region, most likely it is appendicitis.
You can also ask the child to lie on his right side and gently pull his legs towards his body. In this case, the pain usually subsides, which is again characteristic of of this disease.
Appendicitis in a 6-year-old child, for example, can be checked by lightly pressing on the area where it hurts. If the discomfort subsides, you can safely call ambulance. As soon as you remove your hand from this place, the pain should reappear.
It is important to note that this kind of self-diagnosis is necessary only in order to urgently Call a doctor, because treating this disease is impossible without surgery.
What not to do?
Experts do not recommend giving painkillers, as they will only alleviate the condition for a while and at the same time distort the true situation, and the disease will take its course.
In addition, you should not place a heating pad on your abdominal area. The thing is that heat only enhances the development of the inflammatory process.
Diagnostics
If your child exhibits any of the above symptoms, it is extremely important to seek help from an appropriate doctor without delay. Under no circumstances should you self-medicate. The thing is that many painkillers only distort the primary clinical picture, subsequently significantly complicating the diagnosis.
To confirm appendicitis in a child, the doctor resorts to the following diagnostic measures:
- visual examination + palpation, history taking;
- urine test + complete blood test;
- radiography of the abdominal organs;
- ultrasonography;
The signs of the disease in a teenage girl are similar to the symptoms of ovarian inflammation. In order to exclude this disease, an examination by a gynecologist may be required.
Treatment
As noted above, appendicitis in a child cannot be treated drug treatment, this is where surgical intervention comes to the rescue.
Today, surgery to correct this problem is carried out using the endoscopic method. So, instead of a long incision in the abdominal cavity, the specialist makes a small hole of about 5 mm. A special manipulator will subsequently be inserted through it, which is a replacement for the surgeon’s hands. This operation It is very easily tolerated, blood loss is minimal, and surrounding tissues are not injured. Literally two hours after the appendectomy, the child can walk around the ward independently, and after another two days he is usually discharged.
The only indication for appendicitis in a child is conservative treatment, is the so-called appendicular infiltrate (the appendix and nearby organs are in a fused state). In this case, the patient is prescribed drug therapy. However, literally a month later the doctor still prescribes a planned appendectomy.
Postoperative period
First of all, it is very important to limit excessive physical exercise(lifting weights, cycling or skiing, etc.). Still, the child must adhere active image life. Walking on fresh air, simple housework - all this is useful for restoring the body. Active activities are allowed to be introduced gradually and only after consultation with a doctor.
What should the diet be like?
It is very important to stick to a fairly simple diet in the first weeks after surgery. Certain drinking regime(about two liters of still water per day). On the fourth day you can start giving your child steam cutlets. The diet should consist mainly of light dishes and soups, liquid porridges. It is recommended to feed frequently (about six times a day), but in small portions. If small little patient refuses food, insisting is not recommended.
In the future, it is better to give up all canned food, as well as those foods that provoke increased gas formation in the intestines (legumes, cabbage, grapes, etc.).
Possible complications
Delayed diagnosis of appendicitis in a 4-year-old child (as at any other age) can lead to the development of complications, one of which is perforation. It usually ends in peritonitis.
Another consequence of this disease is intestinal obstruction. It appears when the inflammatory process disrupts the normal functioning of the intestinal muscles.
Blood poisoning is also considered a common complication after appendicitis. Bacteria that enter the blood gradually disrupt the normal functioning of all internal organ systems.
Conclusion
In conclusion, it must be noted once again that this disease is not dangerous. Appendicitis in a 5-year-old child is as treatable as in an adult. In this case, it is important to diagnose inflammation in a timely manner and not put off treatment, as they say, to the back burner. Surgical intervention allows you to forget about this disease forever. We hope that all the information presented in this article will be truly useful to you.
One of the most common acute surgical diseases in childhood - appendicitis. The parents' task is to study warning signs, find your bearings in time and call for help, do not take rash actions in the absence of the necessary knowledge.
Appendicitis is called acute inflammation a vermiform organ (appendix) extending from the cecum. Due to the immaturity of the gastrointestinal tract in children infancy this pathology is extremely rare, but starting from 2 years of age, the risk of the disease increases. About 5% of cases occur in children of the nursery group, 13% - preschool age, more than 80% are schoolchildren. It has been observed that boys are affected by this condition more often than girls.
If patients 4-6 years old can tell what worries them, then it is difficult or impossible to obtain a verbal description of symptoms from children under 3 years old. This is the first feature of the disease in childhood and, accordingly, the main difficulty in diagnostic matters.
The second feature of appendicitis in children is its transience. The pathology develops quickly, often involving the peritoneum: necrosis of the cecum, development of peritonitis.
Inflammation of the appendix is quite insidious disease, skillfully “masquerading” as ordinary food poisoning, flatulence and other types of gastrointestinal dyspepsia. Parents are not always able to assess the danger of symptoms: the thought of serious, health- and life-threatening pathologies often does not even appear.
Causes
The appendix is a kind of “dead end” of the large intestine, and its inflammation is caused by blockage or narrowing of the “outlet” under the influence of a number of factors:
As a result, the cavity of the appendix is unable to empty itself, the outflow of mucus is hampered, pressure on the walls of the organ increases, and swelling increases. The consequence of these phenomena is disruption of blood flow, activation of opportunistic microorganisms, stagnation venous blood. 10-12 hours after the onset of obstruction, inflammation begins. In some cases, it is eliminated by the forces of the body itself, but most often it develops further.
Inflamed appendage The next stage of the disease is the rupture of the inflamed process and the entry of pus and feces into the free abdominal cavity. This process is rapid and can take from 1 to 3 days.
Another reason for infection of the appendix is the proliferation of opportunistic microorganisms living in the intestines. Under favorable circumstances, which include abuse medicines, disruption of peristalsis, they cause inflammation. Microbes can also enter the cavity of the appendix from the outside: through blood or lymph from other affected organs. For example, a relationship has been proven between acute appendicitis and a history of recent nasopharyngeal diseases.
There are also infections directly related to inflammation of the appendix. These include:
- tuberculosis;
- typhoid fever;
- amoebiasis.
There are certain factors that increase the risk of developing appendicitis in children. It is advisable to warn in a timely manner:
- constipation;
- helminthic infestations;
- gastrointestinal diseases;
- excessive zeal in nutrition;
- abuse of sweets with low physical activity;
- lack of fiber-rich foods in the diet.
Maximum possible healthy image child's life, proper, age-appropriate nutrition and regular medical examinations greatly reduce the risk of appendicitis.
Signs of the disease
The key symptom of any inflammation is pain. In some cases, with appendicitis on initial stages it may be unclear and weakly expressed, so the child eats, plays, visits quite calmly educational establishments. And his parents attribute his condition to eating problems, constipation, or even a deliberate lie.
Pain is one of the main signs of appendicitis However, after 1-2 days the picture changes dramatically: the sick child becomes indifferent to toys and favorite activities, refuses to eat, stops jumping, running, and tries to lie down. In this case, complaints of abdominal pain become the main symptom of the disease; possible fever, nausea.
Another scenario is characterized by the sudden development of pathology. Sharp pain behind the peritoneum on the right, radiating to the legs when walking, dizziness, intense nausea, fever, accompanied by a violent reaction of the child to an attempt by adults to touch the stomach.
Both clinical pictures allow parents to suspect acute appendicitis and go to the doctors as quickly as possible.
Again general signs inflammation of the appendix:
- Pain in the right side of the abdomen, near the navel, sometimes radiating to other parts of the body.
- Nausea.
- Disturbances in the gastrointestinal tract, manifested by stool disorders.
- Fever.
Signs of appendicitis in children under three years of age
Children under 3 years of age are mostly unable to tell their parents about specific causes of concern. Malaise and pain are expressed only in an accessible way– we cry, especially in babies under one year old. It's time to sound the alarm if your child:
- cries without obvious reasons(fed, dressed, watered, etc.);
- intensely presses the legs to the stomach;
- refuses food and favorite treats;
- does not allow touching the skin of the abdomen;
- tries not to move;
- sits or lies in an unusual and uncomfortable position for him;
- if he crawls or walks, then slowly, without sudden movements.
In addition to behavioral signs of appendicitis symptoms in children younger age applies:
- fever up to 38-39, sometimes up to 40 degrees, appearing suddenly;
- frequent swallowing of saliva;
- loose stools;
- skin rashes;
- swollen lymph nodes;
- dry mucous membranes.
When found similar symptoms It is mandatory to go to the emergency room of the nearest hospital or the ambulance service! And as quickly as possible.
Signs of appendicitis in preschool and school children
The main symptom, pain, makes itself felt in the vast majority of cases acutely and in the navel area. After a few hours, it gradually moves to the area of the right iliac region and intensifies slightly. The child complains of aching, monotonous pain and nausea. One-time vomiting is possible, most often occurring even before the onset of discomfort in the umbilical area. The temperature rarely rises to 38 degrees, preferring to remain between 37.3-37.8. There are frequent cases of appendicitis in children 8-13 years old without fever.
As the disease progresses, the child’s condition worsens:
- general intoxication increases;
- the skin turns pale;
- mucous membranes become dry;
- nausea and pain increase;
- loose stool appears.
When appendicitis is combined with other infections, for example, viral hepatitis or measles, possible sudden jump temperatures up to 39-40 degrees and the addition of additional symptoms uncharacteristic for inflammation of the appendix.
Atypical picture
Unfortunately, according to " standard scheme“Appendicitis develops only in 30% of children, the remaining 70% undergo an atypical course of the disease. In these cases, the pain is not localized in the right iliac region or near the navel, but at other points. For example, when the inflamed appendix is located in the liver area, the pain initially appears in the stomach area, and only then moves to the right and down. When the process is localized in the pelvic area, urination becomes more frequent, and the process of urine outflow is accompanied by pain radiating to the abdomen. Also when atypical appendicitis pain often appears in the back, in the lower back, behind the sternum, and sometimes in the rectum.
If there is doubt about the diagnosis, the child is prescribed additional examinations: urine analysis, blood analysis, ultrasound of the pelvic organs.
Only a specialist can make a final diagnosis, since the signs of appendicitis fit well into the picture of other diseases. Doctors have at their disposal methods of laboratory and instrumental examination that allow them not only to determine the disease, but also to clarify the form of the disease, the location of the inflamed area, and the severity of the condition.
Parental Actions
The main task of adults is to call for help and not provoke deterioration. If parents do not know what to do, it is better not to do anything, but to wait for help.
In no case and under no circumstances should you:
- Give medications to reduce fever and relieve pain.
- Offer food and drink.
- Warm, rub and massage the stomach.
- Apply local anesthetics, compresses and ointments to the area of pain.
- Give medications that affect the gastrointestinal tract (diarrhea, constipation, flatulence, etc.).
- Try to master the skills of deep palpation with your own hands.
Special danger - folk remedies. If appendicitis is suspected in children, their use is strictly unacceptable, since the risk of allergies, additional infection and unpredictable consequences is high.
What to do?
- Call for help.
- Calm down and try to calm the child.
- Invite him to take the most comfortable place and position for him.
- Explain why you can’t drink, eat or move.
- Collect the documents and things necessary for hospitalization.
- Wait patiently for help.
If it is possible to independently and quickly deliver the child to the doctors, be it a clinic or a surgery emergency room, it is worth doing so.
At the slightest suspicion that a child is developing inflammation of the appendix, an examination by a specialist is needed. Delay is fraught with truly dangerous consequences.