Appendicitis is an inflammation of the appendix of the large intestine, in other words, the caecum. As a rule, this formation is located in the place where the small intestine passes into the large. Also, the appendix can be located in the pelvis, subhepatic space and behind the ascending colon. Thus, the process is not always located in the lower right section. In some cases, it is on the left. As a rule, adults face this disease. However, children can also have this problem. In the review, we will look at how appendicitis manifests itself in children. Diagnosis, methods of treatment and prevention - all these issues will be disclosed in more detail.
Causes of disease
Let's take a closer look at them. What causes appendicitis in children? The trigger factor can be:
- worm infestation;
- frequent constipation;
- dysbacteriosis;
- Sweet abuse.
Functions performedappendix in the body, has not yet been fully elucidated. However, for some reason, it can become inflamed. It is believed that the development of appendicitis is associated with blockage of the lumen of the appendix. In addition, pathogenic microflora can become the cause of the disease. Blockage can be caused by worms, a foreign body that has entered the intestinal lumen, and fecal stones. It also happens that the lumen is blocked due to the excessive growth of the lymphoid follicles contained in the appendix. Congenital anomalies, such as kinking of the process, are also of great importance. At the same time, microorganisms from the intestines can remain in the lumen of the appendix. Microbes can get there with lymph or blood. Appendicitis often develops against the background of diseases such as tonsillitis, acute respiratory viral infections, acute respiratory infections and otitis media. Inflammation of the appendix is caused by infections such as tuberculosis, yersiniosis and typhoid fever.
Bacteria caught in the lumen of the appendix begin to multiply, causing inflammation. As a result, edema and venous stasis develops in the intestinal walls. Subsequently, this can lead to necrosis of the process, rupture of its walls, entry of pus and feces into the abdominal cavity. This is how peritonitis begins to develop.
How to identify appendicitis in a child? Up to 2 years, this disease is extremely rare. This feature is explained by the nutrition of the child, as well as the insufficient development of lymphoid follicles in the process. At this age, the appendix communicates with the intestines through a wide opening. It's pretty hard to cover it up. Closer to 6 years, lymphoid tissue grows. At this time, the likelihood of developingappendicitis increases significantly.
Disease classification
There are two forms of the disease: chronic and acute. Acute appendicitis is subdivided into several more types:
- Appendiceal colic: a mild inflammation of the appendix that resolves after 3-4 hours.
- Catarrhal appendicitis: superficial inflammation without tissue destruction.
- Destructive appendicitis. Two forms are distinguished here: phlegmonous and gangrenous. The first is characterized by covering the inflamed appendix with purulent plaque, which can also accumulate in the appendix cavity. The cause of the development of gangrenous appendicitis is thrombosis of the vessels of the appendix. As a result, the general condition of the body worsens.
- Complicated appendicitis.
The symptoms of the disease in question in babies are different, they depend on factors such as the location of the process, the stage of inflammation and the age of the child. For this reason, the diagnosis of appendicitis in children at home can be significantly difficult.
Signs
What should I pay attention to first of all? Only a qualified doctor can accurately determine that a child has appendicitis. However, parents can pay attention to some symptoms. They mainly depend on the age and individual characteristics of the baby's body.
Signs of appendicitis in 5 year olds:
- sluggishness;
- refusing food;
- lack of interest in games.
The first symptom is a strongpain. The kid himself, without realizing it, may try to protect the diseased area of \u200b\u200bthe body. He presses his legs, lies on his right side, resists palpation.
An obvious sign is also an increase in body temperature to 38 degrees and above. There may be a rapid heartbeat, pallor of the skin, loose stools, vomiting. The younger the child, the more often the urge to vomit will appear. As a result, dehydration develops.
You should also take into account the specific symptoms that may occur with an atypical location of the process. So, for example, pain appears in the lower back or groin. In addition, there are problems with urination and excretion of feces. If the appendix is under the liver, the entire right hypochondrium can hurt.
How to tell if a child has appendicitis? Symptoms in children at 5 years of age are blurred. Inflammatory processes proceed quickly enough. The child begins to behave restlessly, he has no appetite. Stools and urination begin to hurt. The kid does not allow himself to be examined normally and pulls his legs up to his stomach.
At the age of 5, a child's appendicitis usually develops suddenly. It proceeds, as a rule, at lightning speed, and the manifestations may be atypical. The child is not always able to accurately indicate the location of the pain. As a rule, he points to the area near the navel or to the entire abdomen. Not always in children, the above symptoms are observed. The process of inflammation can rapidly worsen, turning into peritonitis. At the same time, the temperaturerises to 40 degrees, the stomach swells, stool retention is observed.
The danger of developing this condition is that many parents believe that appendicitis cannot manifest itself at such an early age. They attribute the pain to poisoning, overeating and other causes. If urgent help is not provided to the baby, the process may burst, which will lead to complications.
Appendicitis in a child at 7 years old is much easier to identify. The kid is already able to accurately indicate the sore spot. As a rule, at the beginning of the development of the inflammatory process, pain is localized in the umbilical and epigastric region. After 2-3 hours, it descends into the right iliac part. Pain in the subhepatic location moves to the right hypochondrium. With a pelvic location, discomfort appears in the suprapubic region. The pain of appendicitis is permanent. This condition definitely leads to sleep disturbance. As a rule, the child refuses to eat, and vomiting may also occur. A frequent manifestation of appendicitis is stool retention. In addition, the heart rate increases significantly. The pelvic location of the appendix causes frequent urination. Catarrhal appendicitis is accompanied by the appearance of a white coating on the root of the tongue. The risk of developing the disease increases significantly with age.
Appendicitis in a 10-year-old child is observed quite often. Despite the fact that the process most often develops according to the classical version, it is sometimes very difficult to make a diagnosis. A child, even with abdominal pain, can continue to attend school. The process gradually develops until the statesharply worsens to the stage of complicated appendicitis. In childhood, a chronic form of the disease is not so common. It is characterized by the development of recurrent seizures in the projection area of the appendix. Nausea and fever may also occur.
What could be the consequences?
In order to prevent the development of complications, it is necessary to diagnose the disease in time and undergo treatment. If this is not done, a number of complications may develop.
These include:
- Tear or perforation of the process: this condition usually causes inflammation of the peritoneum, or peritonitis.
- Appendicular infiltrate.
- Intestinal obstruction.
- Appendicular abscess (abscess): occurs in the area where the inflamed process is located.
- Sepsis (the entry of microorganisms from the inflamed appendix into the blood, entering them into the organs and the formation of ulcers).
Diagnosis of disease
What is she like? How to identify appendicitis in children? Diagnosis is usually carried out by several methods at once. First, the doctor palpates the abdomen. Appendicitis usually causes tenderness in the right iliac region. You will also need a laboratory examination, including urine and blood tests. If necessary, a bacteriological examination of feces is also carried out.
Instrumental diagnostic methods include:
- Ultrasound of the pelvic organs and abdominal cavity;
- electromyography;
- computed tomography;
- radiological examination;
- diagnostic laparoscopy.
Girls of childbearing age may still need to see a pediatric gynecologist.
The doctor, on palpation, will determine soreness (local or diffuse), retention of the abdomen during breathing, excessive tension in the abdominal muscles, symptoms of irritation. Parents should never try to detect appendicitis in children. Diagnosis should only be carried out by a qualified technician. Here you need to have some experience. Sometimes small patients are checked during sleep. Also, a doctor may need a rectal finger examination to make an accurate diagnosis. Thus, it is realistic to reveal soreness and overhanging of the anterior wall of the rectum.
Blood test results for appendicitis usually show an increased number of white blood cells, as well as an increase in the number of neutrophilic white blood cells. Protein and red blood cells may be found in the urine. At 5 years old, appendicitis in a child can be determined by using electromyography. This type of study helps to identify muscle tension in the anterior abdominal wall. The most accurate diagnostic method is an ultrasound examination. It is it that allows you to determine the acute degree of appendicitis, as well as to detect the presence of infiltrates and abscesses in the abdominal cavity.
Appendicitis Therapy
So what's special about her? How to treat appendicitis in children at 7 years old? In this case, parents should follow a few simple recommendations:
- When there is pain in the abdomen, do notpainkillers should be used on their own. Taking such funds can make diagnosis much more difficult.
- Child should not be given laxatives or enemas.
- It is not recommended to apply heating pads or cooling compresses to the abdomen. They can affect the rate of development of the inflammatory process.
- Don't let your child drink too much liquid. If an operation is required under anesthesia, 3 hours before it, you can not eat and drink. With a pronounced thirst, you can simply moisten the child's lips.
- If you experience severe abdominal pain, you should immediately consult a doctor.
Treatment usually involves surgery. Both acute and chronic appendicitis require surgery. Appendicitis in a child can be removed both traditionally and laparoscopically. Both types of intervention are performed under general anesthesia. The duration of the operation is 30-60 minutes. With timely treatment, the prognosis is quite favorable. After the operation, the child should not drink liquids for some time. The surgeon will give precise instructions about the subsequent meal. Small patients are usually discharged 5-8 days after surgery.
Laparoscopic method of operation is more preferable because it is not so traumatic. The surgeon will simply make a small incision, then use a telescopic camera and special tools to remove the inflamed appendix. After such an operation, the child recovers much faster. However, in the presence of complications, surgery is usuallycarried out in an open way.
Treatment of destructive appendicitis
What do you need to know about this? The operation is much more difficult if the disease is accompanied by complications. In the destructive form, the removal of appendicitis in children requires special preoperative preparation. Within 2-4 hours, intravenous fluids are administered to relieve intoxication. It is also necessary to introduce antibiotics to a small patient. During the operation, doctors clean the entire abdominal cavity, remove mucus, bacterial microflora and feces. In this case, a large number of antibacterial drugs are used.
Postoperative stay in the hospital in this case will be longer. After discharge, it is required to monitor the condition of the child. If you have a fever or other symptoms, see your doctor right away.
Perforated appendicitis in 20% of cases ends with complications. An abscess may develop in the abdominal cavity after the operation. Treatment of this condition is selected depending on the individual characteristics of the body. As a rule, it includes antibiotics, detoxification therapy, and removal of pus from the abdominal cavity. Adhesive disease often develops after destructive appendicitis.
Preventive measures
Is it possible to somehow prevent appendicitis in a child at 4 years old? Of great importance in this case is the observance of the correct diet. Parents should be serious about formulating a diet forchild. The frequent use of such harmful products as sweets, chocolate and chips provokes the development of the disease. It is also necessary to monitor the regularity of the chair. All diseases in acute and chronic form in a child must be treated with high quality, preventing the development of complications. A simple sore throat can become a trigger for the development of appendicitis in childhood.
Advice to parents and feedback
How dangerous is appendicitis? Symptoms in children as young as 10 may not be as obvious, increasing the risk of misdiagnosis. The child cannot always describe in detail what he feels, where exactly the pain is localized. While doctors are sorting through possible options, inflammation begins to progress and reaches a dangerous stage. Therefore, parents should be aware of a few obvious signs. Initially, there is usually acute pain in the abdominal cavity. It can be localized in any area, but most often concentrated on the right. A forced posture usually helps to reduce pain for a child. The inflammatory process is often accompanied by vomiting. Usually after it the child does not feel better. Particular attention should be paid to this, since in case of poisoning, vomiting usually leads to relief.
How else can appendicitis be detected? Reviews of parents whose babies have suffered an illness indicate that the symptoms in children at the age of 7 will differ from the signs of the disease in adolescents. The inflammatory process in babies, as a rule, is accompanied by a sharp increase in temperature. The older the person, thetemperature increase becomes less pronounced. The course of inflammatory processes can still be judged by the appearance of the tongue. At the stage of development of the disease, a light white coating forms on it, with the appearance of complications, the entire surface is covered with a dense yellowish film. In the case of the development of necrosis, dryness of the mucous membranes is felt.
How else can a preliminary diagnosis of appendicitis in children be carried out at home? Parents should definitely pay special attention to the occurrence of problems with the chair. As a rule, babies usually develop diarrhea. In older children, disorders are more often expressed in the appearance of constipation. If the caecum is in close proximity to the urethra, then difficulties arise in this area as well.
In conclusion
How to properly treat appendicitis in children? Diagnosis of the disease should be carried out only by professional specialists. However, parents can pay attention to some signs. If the child complains of incessant abdominal pain, then urgently need to call an ambulance. Based on the results of the examination, the medical team will decide on the delivery of the child to the surgical department. The further procedure will be determined by the surgeon, ultrasound diagnostician and anesthesiologist. If necessary, you may also need to consult a gynecologist. If the diagnosis is confirmed, the child will be scheduled for surgery. In most cases, with timely treatment, it resolves without serious complications.
Appendicitis is reala serious illness that can lead to negative consequences if it is not treated in time. Therefore, at the first manifestations, immediately contact a medical facility.
