Diagnosing and treating pediatric appendicitis

Abdominal pain is one of the most common reasons children visit the emergency department. Appendicitis is the most frequent surgical emergency in pediatrics, affecting approximately 80,000 children in the U.S. every year. At Children’s Minneapolis and St. Paul emergency departments our pediatric surgeons perform about 750 appendectomies every year.

To help improve pediatric care for children across the U.S., clinicians at Children’s Hospitals and Clinics of Minnesota are currently working with non-pediatric emergency departments to diagnose appendicitis without using CT scans whenever possible. It’s one of the first implementation studies funded by the National Institute of Health (NIH) for pediatric emergency medicine and could positively affect millions of children. Learn more about this grant.

Appendicitis Questions Answered

What is the appendix?

The appendix is a small, finger-like pouch that hangs off of the large intestine.

What is appendicitis?

When the appendix becomes swollen and infected, doctors call that appendicitis.

What are appendicitis symptoms?

  • Belly pain, especially on the the lower right side or near the belly button
  • Nausea and vomitting
  • Loss of appetite
  • Fever, typically 1-2 days after the pain begins
  • Increased urination

Who is most likely to get appendicitis?

It is most common in children between 8-16 years of age, but children (or adults) of any age can get it. There is no way to predict who will be affected by appendicitis, or when.

Can appendicitis be prevented?

There is no way to prevent appendicitis.

Why does appendicitis in kids occur?

There isn’t always an obvious reason, but it’s typically due to bacteria stuck inside the appendix.

How appendicitis diagnosed?

Every scenario is different, but generally, Children’s physicians will first perform a physical evaluation and review the child’s medical history. Then, depending if the patient is at low, medium or high risk, additional tests such as blood and urine tests, or ultrasounds and CT scans, may be used. At Children’s we are typically able to diagnose about 80-percent of patients without using a CT scan.

Are CT scans safe for children?

CT scans can negatively impact children’s health due to the radiation exposure. Our teams know children are more than just “small adults” and their organs and bodies are especially sensitive to radiation. Since our physicians are specialized in pediatric medicine they are able to diagnose most patients using a physical evaluation and less-invasive tests.

How is appendicitis treated?

A surgical procedure to remove the appendix is recommended in most cases. Patients are under anesthesia during the surgery so they don’t feel any pain. The appendix is removed in a surgery is called an appendectomy and is one of the most common surgeries performed at a pediatric hospital. The surgery itself is quick, typically lasting 30 to 60-minutes, and may require a few days in the hospital to recover, especially if the appendix ruptured before removal.

Why do you need to remove the appendix?

If the infected appendix isn’t removed in time, it can burst and spread infection throughout the abdomen which can be fatal.

Why bring my child to Children’s ER if I suspect he or she is suffering from appendicitis?

We perform more appendectomies than any hospital in the state. Our surgeons are specialized in pediatric medicine, and they understand kids’ bodies aren’t just “small adults” – and know how to diagnose and give the most effective treatments possible.

How do I care for my child after surgery and what is the typical recovery timeline?

After an appendectomy, your child may stay in the hospital for a few days of recovery, especially if the appendix ruptured prior to being removed. Most children recover from an appendectomy fairly quickly and can return to normal activities within one to two weeks.

Children’s Pedcast

Dr. Anupam Kharbanda answers questions about the signs and symptoms of appendicitis in children and how it’s treated.

Video resources

5 signs of Appendicitis

Appendicitis – why my child?