Appendicitis is the infection and inflammation of a tiny part of the intestine called the appendix. The Appendix is a small, finger-like pouch that branches off from the intestine. It doesn’t seem to have any specific function in human beings, and removal is not harmful. Dr. Geeta Kekre is one of the Best Pediatric Appendicitis Surgeon in Pune

The lining of the appendix secretes mucus. Sometimes, the mouth of the appendix gets blocked by a tiny bit of feaces (stool). As a result, the mucus secreted by its lining cannot escape and it begins to build pressure inside the appendix. At the same time, bacteria begin to proliferate causing infection and inflammation. This is what we call appendicitis. Pus begins to form in the appendix, leading to further build up of pressure. If the appendicitis is left untreated, the inflamed appendix can ultimately burst allowing the bacteria and the pus to spread all over the abdomen.

The most common symptom of appendicitis is abdominal pain. It usually starts like a vague stomach ache, but the pain gradually becomes worse and localizes to the right lower part of the abdomen. There may be some fever as well, and a few episodes of vomiting are not uncommon. The child generally shows an aversion to food and you wouldn’t be able to coax him or her to take a bite of even their favorite junk food. Appendicitis is an emergency, and the child should be seen by a doctor immediately.

To diagnose appendicitis in a child, a detailed history and physical examination by a pediatric surgeon are crucial. The surgeon will also order certain blood tests. Depending on the findings of the clinical exam, the surgeon will further order imaging studies. This may be an ultrasound or a CT scan, depending on the clinical scenario.

The treatment of appendicitis is removal of the infected and inflamed appendix. The surgery to remove the appendix is called an appendicectomy (US: appendectomy). It is one of the most common emergency procedures performed by paediatric surgeons across the world. Traditionally, appendectomy was performed through an incision in the right lower quadrant of the abdomen. In many acute cases, the incision needs to be quite big. Now a days though, nearly all appendectomies, including appendectomy for a ruptured appendix, are done laparoscopically. Laparoscopy is a minimal access technique in which a narrow surgical camera, and fine instruments are introduced into the abdomen through tiny cuts not more then 5 mm in size. These instruments are used to perform the appendectomy following the same principles and steps as conventional surgery. However, at the end of a laparoscopic surgery, the child is left with a much smaller wound with less pain and less scarring.

After an appendectomy, your child will be asked to avoid all solid food as well as water for some time. This duration depends on the severity of appendicitis. Once your child is able to accept food and water, has had a bowel movement, and has a satisfactorily healing wound, you will be discharged home. Antibiotics and pain medicines are given as needed. The child is encouraged to move around and participate in light activities rather than lie in bed all day.

Your first follow-up with the surgeon is usually ten days after discharge. Once the stitches are out and the wounds have healed well, your child can go back to all his or her activities, including sports. Return to full activity is earlier in laparoscopic than in open surgery, but in both cases, there are no lifestyle or diet restrictions in the long run.