Appendicitis symptoms, diagnosis and treatment

Mar 28, 2010 at 6:33 p.m. ET

What are the warning signs of appendicitis -- an inflammation of the appendix? A pediatrician offers some information.

Appendicitis warning signs

The question:

What are the signs of appendicitis? - Maria in Easton, Maryland

The Pediatrician Answers:

Appendicitis is an inflammation of the appendix, a small portion at the beginning of the colon (large intestine). The inflammation usually follows blockage of the appendix by a fecolith (stool stone). It is most common in children and adolescents from about 3-5 years up through young adulthood.

Generally, it presents with nausea, vomiting, abdominal pain, and fever. The pain usually starts in the mid-abdomen and works toward the right lower abdominal area. It usually hurts to touch the abdomen.

Many other things need to be distinguished from appendicitis. It can be confused with gastroenteritis (stomach flu), urinary tract infection, colitis, ovarian cysts, pelvic inflammatory disease, ovulatory pain, tubal pregnancy, sprains of pelvic ligaments, testicular torsion, hernias, and even pneumonia. The appendix is sometimes located in an unusual location and the pain is not in the lower right abdomen.

Appendicitis is extremely difficult to diagnose in infants and toddlers, since they often present with atypical findings. If your child has abdominal pain, it's a good idea to call the doctor. The doctor can help you sort out whether or not the child needs to be seen immediately for the pain. Fortunately, the appendix can be seen on a CT scan of the abdomen; this test is often used to help diagnose the condition.

Treatment for appendicitis is removal of the appendix (appendectomy) by surgery.

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