Appendicitis in a child Flashcards
What is the definition of appendicitis in a child?
Inflammation of the appendix
In which age group is appendicitis uncommon?
<3 y/os
What is the general epidemiology of appendicitis in a child?
It is the commonest cause of abdo pain that requires surgical intervention
What are the symptoms of appendicitis?
Anorexia
Vomiting (only a few times)
Abdo pain
What is the nature of the abdo pain in appendicitis in a child?
Starts central and colicky
Moves to RIQ (due to localised peritoneal inflammation)
Aggravated by movement
What are the signs of appendicitis in a child?
Flushed face and bad smell in mouth
Pyrexia (37.2 - 38 degrees)
Pain aggravated by movement
Tenderness and guarding in RIF
What is the role of lab/imaging investigations in appendicitis in a child?
Aren’t consistently helpful to diagnose
But some features may help to support diagnosis
What are some investigations that can be done in appendicitis in a child?
Neutrophilia (but not always)
WBC/organisms in the urine - due to inflamed appendix being next to ureter/bladder
Ultrasound - thickened + non compressible appendix and increased blood flow
If suspecting appendicitis in a child, what is important to do and why?
Regular observation and clinical review
Due to risk of progression
What are the management options for appendicitis in a child?
Conservative management
Appendicectomy
Laparotomy + fluids + Abx
When is conservative management of appendicitis in a child appropriate?
Palpable mass in RIF but no signs of generalised peritonitis
What is conservative management of appendicitis in a child?
IV Abx + surgery after a few weeks
When is an appendicectomy performed?
In uncomplicated appendicitis
When is a laparotomy warranted?
In complicated appendicitis
What are some complications of appendicitis in a child?
Presence of appendix mass
Abscess
Perforation
Complications from surgery
