Appendicitis

[DrHerbert]

Do they always take the appendix out? 10 year old was home from school yesterday with all the classic symptoms: painful stomach right hand side, low grade fever, vomiting, pain when moving.

Tests have now come back that appendix is infected, although earlier they said blood and urine was negative for appendicitis. They’re going to do an ultrasound. Giving him antibiotics for the infection. Have been told he’ll have it removed by keyhole surgery at some point today but also told they might just give antibiotics and send him home if ultrasound isn’t too bad??

Anyone any experience with this?

No. Unclear cases we will watch and wait. Kids commonly get a condition called mesenteric addenitis with viral infections which presents very similar

Urine tests can't look for appendicitis, only urine infections

Theres big trials going on abx vs surgery esp out of hours to see if we are doing cases unnecc

If the appendix bursts, it'll result in peritonitis and that's fatal. I don't understand why your child isn't in hospital right now, being prepped for surgery.

Yes it think so. Both ds have had them out. Younger ds had a blood test in A and E and then went straight to theatre. Both recovered very quickly and it was key hole surgery. Hope your dc does ok

He’s in A&E, just keep being told different things. It’s also incredibly busy, and there was an admin error that meant he was discharged on the system at one point so no one knew he was here for two hours until I double checked what was going on.

I thought the urine was to check for possible urine infection but the nurse said bloods/urine was negative for appendix?! Then the next thing he’s given antibiotics as the tests have shown signs of infection. It’s all a bit confused here!!

Have been told keyhole surgery later today and also that he’ll just be given antibiotics and sent home 🥴

Increasingly there is evidence that antibiotics can treat some mild cases of appendicitis. Things will depend on the individual surgeon and your child's unique case

It was probably a slip of the tongue thing said in a hurry. Urine can only tell urine or kidney infections

Many we take to theatre with "appendicitis" often have totally normal appendix when you get inside so surgeons, rightly, don't want to expose a child to the risks of surgery if they aren't strongly convinced of benefit. Lots of these kids are watched closely on the ward to see illness progression and don't actually need surgery so that can be where confusion arises

https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-023-02108-1#:~:text=Conclusions,or%20complicating%20the%20original%20illness.

This is a big study combining the results of lots of other studies comparing treating appendicitis with antibiotics vs surgery

Im an anaesthetist not surgeon though so couldn't tell you the nuances

They are in hospital, being treated by doctors. Don't scare monger. Perforation is really not that common

My daughter had suspected appendicitis a couple of years ago. We were told that they always remove in children as they recover so quickly and that if they didn’t the appendix would likely cause problems later down the line for them. When my daughter was in an and e the registrar was convinced it was appendicitis so she was admitted for further testing. The next day the surgeon visited her with lots of students and wasn’t convinced as she looked quite well then. One of the students suggested an mri which the surgeon agreed to. She was then whisked to surgery. Another surgeon performed the operation and came to visit the next morning and confirmed the appendix had been inflamed.

Try not to worry, the recovery went really well. She was in pain the next day but fine after that. By the weekend she wanted to go trampolining! She was 6.

I'm sure DC is in good hands.

20 years ago I walked into A&E doubled over. The doctor prodded my appendix, I screamed, he sent me pretty much straight into the operating theatre. But 20 years is a long time!

He’s going for surgery, seen the surgeon and anaesthetist, just waiting to be called, they didn’t do the ultrasound in the end they’re just going with the pain symptoms and blood test results. Things like pain on the right when pressing on the left.

Thanks for all the info, no one in my family has ever needed their appendix out before.

Good luck with everything. As pp said, it's usually a speedy recovery. The keyhole scar is really small.

Hope DS is recovering well op. We had this last Christmas with my little girl (5). Turned out hers had burst and she was very poorly with sepsis. We had been in a&e the night prior to her being admitted and was sent home being told it was muscular! In hospital for a week on IV meds and she made a full recovery after a week off school and no PE for 6 weeks.