smallRW.gif (2706 bytes) Early Diagnosis of Appendicitis Reduces Hospital Stay

CHAPEL HILL, N.C., March 28 /PRNewswire/ -- Early diagnosis of appendicitis in a child can reduce the hospital stay by as much as 12 days following surgery by lowering the risk of complications. If a child with appendicitis has surgery within 24 hours after symptoms are first noticed, there is a 75 percent chance the appendix can be removed before it ruptures. But if surgery is delayed for even one day, the likelihood of avoiding a ruptured appendix goes down to only 20 percent.

A child with an unruptured appendix usually needs to remain in the hospital only one to two days following surgery, whereas surgery for a ruptured appendix can require seven to 14 days of hospitalization and treatment with antibiotics. A ruptured appendix puts the patient at greater risk for inflammation of the abdominal walls and for infection, bowel obstruction and adhesions that can cause infertility in girls.

For all those reasons, it is important that parents be on the lookout for the symptoms of appendicitis so that it can be diagnosed and treated as soon as possible.

"Appendicitis usually causes a loss of appetite, abdominal pain -- especially in the lower right abdomen -- and vomiting," said Dr. Lesli Taylor, a pediatric surgeon at the N.C. Children's Hospital. "The child may also have a low-grade fever and some diarrhea. The symptoms come on rapidly in an otherwise healthy child."

Because the symptoms of appendicitis are similar to those of other common ailments, such as constipation or gastroenteritis (inflammation of the lining of the stomach or intestines), parents may not take the child to the pediatrician immediately, and the pediatrician may not immediately refer the child to a surgeon.

"We can increase early diagnosis of appendicitis by instructing children to let us know anytime they are not feeling well," Taylor said. "Any child with abdominal pain persisting longer than eight to 12 hours should be seen by a doctor. Early examination by a pediatrician or family physician and referral to a surgeon will go a long way toward lowering the chances of a ruptured appendix."

About 7 percent of people have appendicitis sometime during their lives. It is most common in school-age children.

Physicians can often diagnosis appendicitis by examining the patient. They may order certain tests, such  as a white cell count, urinalysis, x-ray or, occasionally, a CT scan, to confirm the diagnosis.

An appendectomy -- removal of the appendix -- can be performed through an incision in the abdomen a few inches long or, in some cases, with a laparoscope, which leaves a smaller scar. 

SOURCE: University of North Carolina Health Care

ST: North Carolina

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Posted March 28, 2001.

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