Digestive and Gastrointestinal Conditions


What is appendicitis?

Appendicitis is swelling of the lining (wall) of the appendix that causes inflammation and infection. The appendix is a small, narrow pouch attached to the large intestine in the lower-right belly (abdomen).

Appendicitis occurs when small, stonelike pieces of stool (feces) block the opening of the appendix. A virus may also cause swelling and blockages in the appendix, which can lead to appendicitis. An inflamed appendix may burst if not removed. This can spread infection around the belly and lead to more serious medical problems.

Appendicitis in children

Anyone can develop appendicitis, but it is most common in children ages 4 to 15. About 1 out of 12 people will get appendicitis during their lifetime.

Appendicitis at Seattle Children’s

Appendicitis is most often treated surgically through a procedure called an appendectomy (pronounced ah-pen-DEK-toe-me). Your child does not need an appendix and can lead a healthy life without it.

  • Our surgery team performs more than 350 appendectomies each year, making it the most common emergency surgery at Seattle Children’s.

    Our surgeons are specially trained in pediatric surgery, which means they understand children’s needs and how their bodies differ from adults’. Our pediatric anesthesiologists also have extra training in how to give pain medicine to children to ensure the safest care possible.

  • Our doctors and nurses are always available to help. We will provide thorough instructions on how best to care for your child after surgery and will call to check on your child a few days after leaving the hospital.

Symptoms of Appendicitis

For children 2 years old and younger, the most common signs of appendicitis are pain in the lower belly, vomiting and swelling in the belly.

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

Other possible symptoms:

  • Loss of appetite
  • Stomach ache
  • Vomiting
  • Diarrhea
  • Low-grade fever (or high fever if the appendix bursts)
  • Swollen or bloated belly

What you should do if you suspect appendicitis

Call your doctor or bring your child to our Emergency Department right away if you suspect appendicitis. Do not give your child anything to eat or drink or any medicine for the pain unless instructed by your doctor.

Diagnosing Appendicitis

It can be hard to determine if appendicitis is the reason a child’s belly hurts. The doctor will ask for a detailed history of your child’s illness and examine your child’s belly to look for tender spots.

We can often diagnose appendicitis using results from blood tests, urine tests and an ultrasound (PDF). Using ultrasound prevents children from being exposed to the radiation in X-rays (PDF) and computed tomography (CT) scans (PDF).

Treating Appendicitis

Appendicitis treatment usually involves surgery to remove the appendix, called an appendectomy. In many cases, this surgery will take place shortly after a child is diagnosed.

Your child will be given general anesthesia to make them sleep during the hour-long surgery so they do not feel pain.

Whether or not the appendix burst, your child may need a nasogastric (NG) tube, which passes through the nose into the stomach. This helps keep your child’s stomach empty so the intestines can rest and helps prevent your child from vomiting. The tube is removed once your child is ready to eat.

  • If your child’s appendix did not burst, they will stay in the hospital for 1 or 2 days after surgery. As your child feels ready, they can eat and slowly resume activity.

  • If your child’s appendix burst, doctors may delay surgery so they can give antibiotics first. Your child will stay in the hospital at least 3 days or longer and will receive antibiotics and fluids through an IV during their recovery. They will not be able to eat or drink right after surgery.

  • We will teach you how to care for the incision, explain what kinds of food or medicine to give your child and tell you if you need to limit your child’s activity before you leave the hospital. You will need to keep the incision clean and dry until it heals.

    • If the appendix burst, the surgeon will see your child in 1 to 3 weeks.
    • If the 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, no further follow-up is needed.

Contact Us

Call your doctor immediately or bring your child to our Emergency Department if you think your child has appendicitis. Contact our Pediatric General and Thoracic Surgery Department at 206-987-2794 if you have questions about appendicitis treatment or care after surgery.