Appendicitis is the infection or inflammation of the organ called the appendix. The appendix is a blunt intestinal protrusion at the beginning of the large intestine. Its projection on abdominal examination is the “right lower quadrant”.
Appendicitis is the name given to the inflammatory disease of this organ. It is the most important cause of “acute abdomen (abdominal disease requiring emergency surgery)” in childhood, which can be encountered in 10% of children on average.
The most important reason why it is more common in childhood is that the lymph node system and immunity are more active in children. Swelling of the appendix with swelling of the lymph nodes at the head of the appendix can lead to appendicitis. Therefore, appendicitis may develop after or during upper respiratory tract infection or diarrhea. The appendix is an organ with a narrow inner diameter, so it can be easily occluded. Hardened poop particles (fecalites), intestinal parasites, fruit seeds are the most common causes of obstruction.
The disease is in the “acute” stage when the appendix starts to become obstructed. However, with the obstruction, pus begins to collect in the appendix and its circulation is impaired. At this stage, “appendicitis” is actually not a very complicated disease. However, if the circulation is disturbed and the pus starts to spread into the abdomen with the puncture of the appendix, appendicitis turns into a disease that threatens the life of the person and causes consequences that can affect him throughout his life. The most basic aim is to eliminate appendicitis in the acute stage before it reaches this stage.
Appendicitis rarely presents with classical findings. If the difficulty of examination in children is added to this, delays in diagnosis are usually encountered in childhood. The most basic findings are abdominal pain, loss of appetite, nausea, vomiting and fever. However, examination findings may not be completely consistent in any patient. The most important diagnostic tool for appendicitis is the experience and examination findings of the examiner.
Abdominal pain initially begins around the navel and cannot be precisely localized, but as the disease progresses, the pain localizes to the right lower quadrant. Pain is a constant pain that tends to increase in character. However, this is a classic history of pain, in most patients the pain does not conform to this classic pain character, it is often encountered with appendicitis that starts with only diarrhea, only vomiting or fever.
In the diagnostic phase, the most important examination is listening to the complaints and abdominal examination. In the examination, tenderness in the abdominal region and the application of movements that increase the pain guide the pediatric surgeon. Apart from the examination findings, laboratory tests and radiological examinations are only auxiliary parameters that help to diagnose and diagnose other possible diseases. A patient who has no signs of examination but is diagnosed with “appendicitis” on ultrasonography is not operated. If the diagnosis is not made on time, children may be harmed by this disease, late diagnosis increases the possible side effects, but there is often “unnecessary operation anxiety” in families in cases where they can decide to operate immediately. Here, a truly “experienced pediatric surgeon” is the definitive solution.
The only and definitive treatment is to quickly remove the infected organ from the abdomen before the infection spreads to the abdomen and body. The surgery can be performed with open or closed method (laparoscopically).
Appendicitis is not a disease to be feared today. However, it is a disease that can still pose a danger to children and can lead to serious disability or death due to the inability of children to express themselves, the fearful examination of them, the use of unnecessary antibiotics and painkillers, and the progression of disease findings.
In cases of abdominal pain and the written findings, it is very important to apply to a center with pediatric surgery without using medication, in order to prevent rapid diagnosis or unnecessary surgery.
