The cecum ends in a small vermiform appendage. This part of the body is rudimentary and called appendicitis, its functional purpose has not yet been clarified. The appendix is susceptible to inflammatory processes that occur at any age, including the infant period.
Can there be appendicitis in a child?
The examined pathological condition is diagnosed mainly in children, especially 5-15 years. Some parents of babies, observing the characteristic signs of the disease, doubt whether there can be appendicitis in a one-year-old child. The answer to this question is positive. The appendix is sometimes inflamed even in newborns.
Appendicitis in children - causes
Still no doctor could specify the exact factors that provoke the described disease. Supposedly, the causes of inflammation of the appendix consist in the simultaneous occurrence of 2 conditions:
- obstruction of the appendix;
- presence of a pathogenic microflora in the caecum.
Acute appendicitis in children
The blockage of the vestigial organ can occur for several reasons. Appendicitis in children makes its debut with:
- foreign bodies in the caecum;
- parasitic infestations;
- hyperplasia of lymphoid follicles;
- congenital anomalies in the structure or location of the organ;
- fecal stones.
Inflammation of the appendix of the cecum begins after the attachment of the bacterial flora. This is facilitated by the following circumstances:
- transferred infections;
- low activity of the immune system;
- inflammatory processes in nearby areas.
Chronic appendicitis in children
Theoretically, there is an independent and secondary form of this type of pathological condition. Most doctors deny the primary chronic inflammation of the appendix, because the acute type of disease always involves the removal of a rudimentary organ. Conservative methods of treatment and cases of arbitrary relief of the pathological process are not present.
Rarely do children have a secondary chronic inflammation of the appendix - the symptoms of the disease appear several months after the operation. Symptoms of the disease are similar to an acute condition, but less pronounced, "blurred". For the development of this form of pathology, it is necessary to have a stump from the excision of the appendix, about 2 cm in length.
Appendicitis in a child - symptoms
It is difficult to suspect the considered illness in children, especially at an early age, when the baby can not clearly describe his own sensations. The signs of inflammation of the appendix in a child are less specific than in an adult. Worm-like process in children is often localized not in a typical zone, right iliac region. He may have other arrangements:
- retrocecal - behind the cecum;
- hepatic - near the gallbladder;
- pelvic - in the region of the waist.
Because of such nuances, most parents do not know how to determine appendicitis in a child , and connect the symptoms that arise in children with diseases that have a similar clinical picture. For this reason, it is important not to try to perform the diagnosis yourself and resort to home treatment methods. In case of any worrisome symptoms, you should immediately contact a qualified specialist.
The first signs of appendicitis in children
An early clinical picture of the pathology is noticeable in the behavior and overall well-being of the baby. The first symptoms with appendicitis include:
- apathy;
- drowsiness;
- irritability;
- deterioration of appetite;
- capriciousness;
- stool disorders;
- nausea ;
- vomiting;
- dehydration ;
- increased body temperature;
- pain in the abdomen, lower back.
In infants it is more difficult to suspect appendicitis - symptoms in infants:
- frequent causeless crying;
- lethargy;
- turning on the left side;
- lack of appetite;
- vomiting;
- resistance to touching;
- attempts to pull up his legs, bent at the knees, to the stomach.
Pain in appendicitis
The described symptom of the disease can be localized in different parts of the body, depending on the location of the vermiform appendage. Signs of appendicitis in children necessarily include pain syndrome, which is felt in one of the following zones:
- epigastrium;
- around the navel;
- right iliac region;
- underbelly;
- small of the back;
- above the pubis or in the groin;
- near the liver.
Often the child is not able to accurately explain exactly where he feels pain, and points to the entire abdomen. Unpleasant sensations in children sometimes irradiate to other parts of the body:
- crotch;
- back;
- genital organs;
- stomach;
- legs;
- ureter;
- rectum.
Temperature with appendicitis
Heat is not considered a specific symptom of inflammation of the rudimentary process in children. Measurement of body temperature is not a reliable way how to recognize appendicitis in a child. The pathological process at an early age progresses very quickly, so the immune system does not always manage to react to it typically in the form of fever or fever. Normal temperature often accompanies appendicitis - the symptoms in children are limited only by pain and dyspeptic disorders. Heat occurs at later stages, when the appendix is ruptured.
Signs of peritonitis with appendicitis
Because of obvious difficulties in diagnosing the presented pathology, most children enter the clinic already with a severe stage of the disease. Peritonitis with appendicitis at an early age (2-5 years) develops almost instantaneously, sometimes from the moment of inflammation to rupture of the rudimentary process takes only a few hours. Specific symptoms of this condition:
- very high body temperature, up to 40 degrees;
- markedly swollen abdomen;
- pallor of the skin;
- stool retention;
- intense cutting pain in all areas of the abdomen;
- severe vomiting.
Complications of appendicitis in children
This disease is thoroughly studied by surgeons and belongs to the group of pathologies with a favorable prognosis. The only reason appendicitis may be complicated is that the symptoms in children were ignored or detected too late. In such cases, the inflammatory process progresses very quickly and leads to dangerous consequences. Appendicitis in a child can provoke the following problems:
- abscess - abscess in the abdominal cavity;
- sepsis - entry into the blood of pathogenic bacteria, generalized damage;
- perforation of the appendix - peritonitis;
- obstruction of the intestine - obstruction ;
- appendicular infiltration - limited inflammation of the peritoneum;
- adhesive adhesion - proliferation of connective tissue.
How to diagnose an inflammation of the appendix?
Press, crumple and feel the stomach in children with suspicion of the described disease is strictly prohibited. Inflammation of the process of the cecum should be diagnosed by a specialist, therefore, at the slightest symptoms of the disease, it is important to immediately contact the clinic. It is possible to presume this pathology by some specific visual signs.
How to determine the inflammation of the appendix in children - simple tests:
- Przewalski. It is difficult or painful for a child to raise his right leg.
- Rizvan. With a deep inhalation, unpleasant sensations in the iliac region intensify.
- Sitkovsky. Intensification of pain in the supine position on the left side.
- Karavaeva. Increased discomfort during coughing.
- Zatler. Cutting pain in the iliac region when the rectified right leg is raised in the sitting position.
Additionally, appendicitis is confirmed by the obvious symptoms in children listed above. If a child has one or more of these symptoms, it is important to immediately call an emergency medical team. Without adequate therapy, the inflammatory process will progress rapidly, provoke peritonitis and other dangerous complications.
The hospital uses instrumental methods of diagnosing appendicitis in children:
- ultrasonography;
- radiography;
- Irrigoscopy ;
- computer or magnetic resonance imaging;
- radionuclide analysis.
When an accurate differential diagnosis can not be established, and the child's well-being deteriorates rapidly, laparoscopy is recommended. This minimally invasive surgical intervention allows us to examine the condition of the appendix with a microscopic camera. Often diagnostic laparoscopy turns into therapeutic manipulation.
Surgery for appendicitis
Removal of the appendix is prescribed after a short course of antibiotics. Antimicrobial drugs help suppress the inflammation of the appendix and simplify its excision, alleviate the symptoms of the disease. Surgical intervention can be carried out in 2 ways:
- Open (classical) method. In the lower part of the abdomen a small incision is made with a scalpel, through which the affected appendix is removed. The wound is sutured, sometimes drainage is installed in it to release purulent masses and excess fluid. After completely eliminating the symptoms of infection, the tube is removed, and sterile dressings with medicines are applied to the healing incision.
- Laparoscopic method. The surgeon gets access to the appendix through 2-4 punctures. One of them introduces a microscopic camera, the others - special flexible tools. This technique of surgery is less painful and is characterized by a short rehabilitation period, but it is suitable only for simple cases of appendicitis in children, when there are no symptoms of peritonitis and rupture of the appendix has occurred.