- Hello.
My name is Corey Iqbal.
I'm a pediatric surgeon
at Overland Park Regional Medical Center
and the medical director
of pediatric and fetal surgery there.
Today we're talking about appendicitis.
Appendicitis is a very common illness.
It's very common in children,
and it creates a lot of anxiety for parents
because it is so common.
In fact, it's the number one reason
for children to need
to have any sort of abdominal surgical procedure.
So what is the appendix?
The appendix is a small organ.
It looks kind of like a worm, almost like my pinky finger.
And it hangs off the large intestine,
sits down on the right lower part of the tummy.
And the inside of it has a small little opening
that gets plugged with poop, and that blocks it
and leads to an infection on the other side.
It's no different than getting a pimple on your face.
The pore gets blocked, and you end up with a zit.
Unlike the zit on your face though,
we don't want to pop the appendix.
Otherwise the infection would spill in the abdomen
and the child would get very, very sick.
Appendicitis typically presents with abdominal pain,
and that's what is very stressful for parents,
because abdominal pain
is a very common complaint among children.
I have three kids.
Almost weekly, one of them has got a tummy ache.
So how do we distinguish what is a serious stomach ache
that the tummy ache that needs to be evaluated
by a healthcare provider,
or it's just the run of the mill tummy ache
that's going to resolve within a few hours.
The most common causes of a tummy ache in a child
is either constipation or viral gastroenteritis.
But you definitely have to be concerned about appendicitis,
particularly when the tummy ache persists
beyond 12 or 24 hours.
The typical course for appendicitis
or the presentation of appendicitis
is that the child will complain of a vague tummy ache,
kind of around the belly button.
And that's the early phase of appendicitis,
when the appendix just starts to begin to swell.
As the appendicitis worsens,
the appendix becomes inflamed on the outside
and turns into a hot poker.
When that happens,
the pain moves from around the belly button right
to the right lower part of the abdomen.
And so when there's a tummy ache
that starts with vague abdominal pain,
that then moves to the right lower part of the tummy,
that needs to be taken seriously as possible appendicitis.
When that happens, it's very painful for the child to move.
So you may notice thechild just wants to lay still.
They may walk with a limp.
They may have other symptoms, such as a low grade fever.
They don't want to eat oftentimes,
and they may even throw up.
Those are all warning signs
that the child may have appendicitis
and need to be evaluated.
They should be seen by some healthcare provider
that can examine their tummy
and make a determination
if they feel that this is consistent with appendicitis.
There are pretty typical findings on exam
that help healthcare providers sort out
whether they think it's appendicitis or something else.
And then simple tests like a blood test,
looking at the white blood count,
which is a marker of infection.
There's something called a C-reactive protein,
which is a marker of inflammation can be measured,
and an ultrasound or a scan to be done
to actually look at the appendix
if there's a high level of suspicion.
If the child has appendicitis,
it's easily treated these days.
Most often that's a surgical procedure
known as an appendectomy,
where the surgeon goes in through small incisions,
laparoscopically, and removes the appendix.
That procedure takes about 30 minutes,
and the child oftentimes is ready to go home the same day.
So just to recap,
when we're talking about abdominal pain in children,
the things to be concerned about is the tummy ache
that persists beyond 12 to 24 hours,
pain that's localized to the right lower quadrant,
or if the child's exhibiting other symptoms,
such as having a fever, refusing to eat or throwing up.
Those would be the signs and symptoms to look forward to
to determine if your child needs to be seen
by a healthcare provider and have additional evaluation.
So I hope this information is helpful for you
the next time your child comes to you
and complains of a tummy ache.
And again, we're always available for you
here at Overland Park Regional Medical Center
to provide care for your children.
Thank you.