Appendicitis

Appendicitis (uh-pen-duh-SY-tis) is inflammation of the appendix. The appendix is a small, narrow outpouching of the large bowel in the lower-right belly. Appendicitis can happen at any age. It is most common in school-aged children and teens.

An inflamed appendix may burst if not removed. This can spread infection around the belly and lead to more serious medical problems.

Call your doctor right away or bring your child to our Emergency Department if they have belly pain that is severe or that lasts more than a few hours.  

• What causes appendicitis?

  Most often, appendicitis happens when the inside of the appendix is blocked by:

  • Small, solid pieces of poop (stool) or other material from the bowel
  • Swelling caused by viruses

We have treated thousands of children with appendicitis. Seattle Children’s doctors have the experience to tell this illness from other problems that cause the same symptoms. Each year our surgeons perform hundreds of procedures to treat appendicitis.

Contact our Pediatric General and Thoracic Surgery Department at 206-987-2794 if you have questions about appendicitis treatment or care after surgery.

• The experts you need are here
  • Our surgeons helped create guidelines to improve diagnosis and treatment of appendicitis for kids in Washington state. The standards mean less radiation exposure for children.
  • Our surgery team performs more than 350 surgeries to remove the appendix each year. This procedure is called an appendectomy (ah-pen-DEK-toe-me). It is the most common emergency surgery at Seattle Children’s.
  • Our surgeons are all board certified in pediatric surgery. Children differ from adults in how they react to illness, pain and surgery. They need care designed just for them.
  • Managing your child’s pain after surgery is critical to their healing. We have the largest team of anesthesiologists who treat only children.
  • Our Emergency Department offers round-the-clock access to Seattle Children’s experts and the full facilities of our hospital.
• Support for your whole family
  • At Seattle Children’s, your family has a full team behind you. This includes doctors, nurses, child life specialists and others. We work together to meet all your child’s health needs.
  • We take time to explain your child’s condition. We help you fully understand your treatment options and make the choices that are right for your family.
  • Our doctors and nurses are always here to help. We explain how best to care for your child at home after surgery. We will call to check on your child a few days after they leave the hospital.
  • We work with many children and families from around the Northwest and beyond. We can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Learn about our services for patients and families.  

For children 2 years old and younger, the main signs of appendicitis are:

• Pain in the belly
• Vomiting
• Swelling in the belly
• Fever

An older child may first complain of pain near the belly button. Over time, the pain moves to the lower-right belly. In most cases, pain does not improve even if the child lies still.

Your child may also have:

• Loss of appetite
• Stomachache
• Vomiting
• Diarrhea
• Low fever (or high fever if the appendix bursts)
• Swollen belly

What to Do If You Suspect Appendicitis

• Call your doctor or bring your child to our Emergency Department right away.
• Do not give your child anything to eat or drink.
• Do not give your child any medicine for the pain unless your doctor tells you to.

Diagnosing Appendicitis

It can be hard to tell if appendicitis is the reason for belly pain. The doctor will:

• Ask about your child’s symptoms.
• Check your child’s belly for tender spots.
• Test your child’s blood and pee (urine).
• Do an ultrasound. This avoids exposing your child to the radiation in X-rays and CT (computed tomography) scans./li>

Treating Appendicitis

Surgery to remove the appendix is the most likely treatment, but some children are treated with antibiotics alone. The surgery is called an appendectomy. Your child does not need an appendix and can lead a healthy life without it.

Most often, surgeons operate soon after a child is diagnosed. Before surgery, we will give your child medicine to make them sleep and not feel pain (general anesthesia). The surgery takes about an hour.

Your child may need a nasogastric tube, which passes through the nose into the stomach. This helps prevent vomiting and keeps your child’s stomach empty so their bowels can rest. We remove the tube when your child is ready to eat.

• If your child’s appendix did not burst

  If your child’s appendix did not burst, they will stay in the hospital long enough to recover from the surgery. Most often this means overnight but some children go home later the same day. At home your child will be able to eat and drink normally and return to normal activity with a few days.

• If your child’s appendix did burst
  • Doctors may delay surgery so they can give antibiotics first.
  • Your child will stay in the hospital 3 days or longer to heal from the surgery and treat the infection.
  • They will get antibiotics and fluids through an IV as they heal.
  • They will not be able to eat or drink right after surgery.
• What happens after my child goes home?

  Before you leave the hospital, we will:

  • Teach you how to care for your child’s incision by keeping it clean and dry until it heals
  • Explain what kinds of food or medicine to give your child
  • Tell you if you need to limit your child’s activity

  Follow-up care depends on your child’s condition:

  • If their appendix burst, the surgeon will see your child in 1 to 3 weeks.
  • If their appendix did not burst, a general surgery nurse will call you at home about 5 days after surgery to see how your child is doing.
  • If your child is doing well at these visits, no further follow-up is needed.