A child’s sharp bellyache
could be appendicitis
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By Bettina Levecke -Children often have
bellyaches. The causes, such as gas, are usually harmless. But a sudden pain
that intensifies could indicate an inflamed appendix, or appendicitis, which
occurs most frequently in childhood and adolescence.
The appendix is a blind-ended, finger-shaped tube projecting from the caecum,
the pouch that is the beginning of the large intestine.
It has no known function. The cause of inflammation is usually unclear.
Faecal matter can become trapped in the appendix, promoting growth of
bacteria. Intestinal parasites or a constriction in the caecum are other
Swallowing fruit seeds is not a risk factor, however. “Melon seeds, cherry
stones and grape seeds don’t lead to appendicitis as widely believed,” said
Wolfram Hartmann, president of Germany’s Professional Association of
Children’s and Young People’s Physicians.
A child with appendicitis may have a fever, nausea and feeling of general
unwellness, said Tim Niehues, director of the Centre for Children’s and
Young People’s Medicine at Helios Clinic in the German city of Krefeld.
“Parents should by all means take the child to a doctor to clear up their
suspicion,” Niehues advised. In many cases the pain shifts to the lower
right area of the abdomen, which he said was “extremely tender — the child
complains of pain when you apply pressure there.” A fairly sure sign of
appendicitis, Niehues said, is when a child no longer feels capable of
bending his or her right leg or jumping down from a chair, or who complains
of pain while doing so.
A child suspected of having appendicitis is often admitted as an inpatient
at a hospital or children’s clinic but not operated on immediately.
“Often the child is given an enema first, then observed for a few hours to
see how the pain develops,” Hartmann said. In nearly half of all cases, the
pain goes away by itself. For the others, the appendix must be surgically
removed, a procedure known as an appendectomy.
“When in doubt, take it out,” said Phillip Szavay, head physician at
Tuebingen University Hospital’s department of paediatric surgery.
“If we don’t take out an inflamed appendix, we put the patient’s health at
risk.” If an inflamed appendix ruptures, pus and contents of the intestines
can leak into the abdominal cavity. Then, Niehues warned, “life-threatening
sepsis occurs within a short time.” Once disease-causing bacteria enters the
bloodstream, “in the worst-case scenario it’s too late for an operation.”
An appendectomy is not risk-free, of course, so parents should acquaint
themselves thoroughly with the risks. “But these operations are performed so
often now that there are relatively few complications,” Niehues said. As a
rule, patients are back home within three and seven days. — dpa