Appendicitis is the inflammation of the appendix. It has an incidence of 1 to 2 cases per 10,000 children per year from birth to 4 years of age, increasing to 25 cases per 10,000 children per year from 10 to 17 years of age. The diagnosis of appendicitis can be difficult in children, because the classic symptoms are sometimes not present. However, understanding the common symptoms of appendicitis is important, as a delay in the diagnosis can be associated with further complications.
Abdominal Pain
Abdominal pain is the most common symptom of appendicitis in children. It usually starts in the center of the abdomen and radiates to the right side. The pain is initially gradual and can become more intense and localized after a few hours. A study done at Johns Hopkins Children's Center concluded that 'the most telltale sign of appendicitis in children is 'rebound' abdominal tenderness or pain that occurs after pressure is removed abruptly from the lower right part of the abdomen'."
Vomiting
Nausea and vomiting can occur after the initial pain and is followed by a loss of appetite. Vomiting that occurs prior to the pain is unusual. In young children, the vomiting can be persistent and exaggerated in nature. Children with vomiting are commonly diagnosed with a stomach virus. However, children with a stomach virus usually tend to improve within 24 hours and can have other symptoms such as diarrhea, which is extremely rare with appendicitis.
Fever
Children with appendicitis usually have a low grade fever (100.4 to 100.9 Fahrenheit) or do not have a fever at all. A high fever (as high as 104) is rare and most likely indicates that the appendix has perforated. Younger children are more likely to have a perforated appendix. A 2007 study conducted in the "Journal of Pediatric Emergency Care" looked at three age subgroups: 3 to 6 years, 6 to 9 years and 9 to 12 years. The study found that the 3- to 6-year age group had significantly fewer cases of appendicitis than the older subgroups, but a higher rate of perforation.
Other Symptoms
The "Journal of Pediatric Emergency Care" study also showed that coughing and the inability to walk were symptoms in many childhood appendicitis cases.
