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What symptom does Infantile Appendicitis have before coming on?

What are the signs before the onset of appendicitis in children? Acute appendicitis in children is a common acute abdomen in pediatric surgery, with abdominal pain, vomiting and fever, of which abdominal pain is the most typical feature. However, children can not accurately express the concept of 'pain', and young children are less sensitive to pain than older children and adults, which makes the diagnosis more difficult. According to statistics, nearly 50% of children with appendicitis have perforated appendix when they are operated on! Pediatric surgery experts remind parents to pay attention to some details, early identify appendicitis, and prevent it from 'slipping away' from their eyes.

The stomach is not very painful, but it is full of pus

4-year-old Hui Hui often says that he has a stomachache, but after defecation, his stomachache stops, so his parents are used to complaining about his stomachache. But a few days ago, I had a stomachache, which almost brought disaster.

That morning, Huihui said she had a stomachache and vomited some breakfast food.

After her mother gave Huihui some digestive medicine, she didn't care much. Towards noon, Huihui's crying became more severe, and her temperature rose to 39 ℃. Her mother began to worry and took her child to the hospital.

After careful examination, the doctor found that the child's stomach was soft and there was basically no tenderness. Considering the fever and vomiting, the doctor suspected that it was a gastrointestinal cold. He told the parents to continue to observe and use antibiotics to eliminate inflammation first, and not to let the child eat or drink water for the time being.

During the observation, Huihui is also called stomachache. At this time, an experienced doctor noticed a detail: when the child got out of bed and walked, he was a bit lame. Press the child's right lower abdomen, the child immediately screamed with pain.

At this time, the doctor judged that the child was suffering from acute appendicitis, and then did B-ultrasound examination, confirmed appendicitis, and recommended immediate surgery.

Surgery found that the child's abdominal cavity is full of thick pus, appendix has purulent, perforated! The doctor said, a little later, the risk is great.

Afterwards, Huihui's mother remembered that she was afraid and didn't understand that the child's stomach didn't hurt very much. How could her appendix be perforated?

Infantile Appendicitis abdominal pain is easy to be covered up

Li Dumiao, chief physician of Department of Pediatrics, the First Affiliated Hospital of Fujian Medical University, explained that appendicitis in children is a common acute abdomen, which is mainly characterized by abdominal pain, vomiting and fever, but the specific manifestations of each child are different.

Abdominal pain is the first symptom, but because children themselves can not accurately express the concept of 'pain', vomiting, crying, irritability, refusal to eat, fever, and fear of doctors and injections also mask children's response to pain.

In addition, some 'antipyretic agents' can relieve pain and easily cover up the disease. Therefore, many parents of children with appendiceal perforation have such a feeling that the child does not seem to have much abdominal pain, how can the perforation occur? Secondly, the child has nausea, vomiting and loss of appetite, so it is often misdiagnosed as gastroenteritis. Appendicitis in children also has fever around 38 ℃, which is often misdiagnosed as respiratory tract infection. However, appendicitis is usually characterized by abdominal pain before fever, and the body temperature gradually increases with the aggravation of the disease. When appendicitis is caused by perforated appendix, a high fever above 39 ℃ may appear.

Several details of appendicitis

Then, how to detect appendicitis in time and treat it early? Chief physician Li Dumiao suggests paying attention to some details, early identifying appendicitis, and not letting it 'slip away' from under his eyes

1. Appendicitis usually has abdominal pain first, then fever, and abdominal pain is persistent.

2. In case of abdominal pain, children like to lie on the right side and bend their legs slightly. Children rarely lie on the left side, because the position of the appendix is on the right. If they lie on the left side, the inflamed cecum will be affected and sagged, aggravating the pain.

3. There are tenderness points in the right lower abdomen, and some children have abdominal muscle tension. Because the child is unwilling to cooperate, it is better for the mother to hold or breast feed the child during the examination to distract the child's attention, and then touch the child's abdomen to observe whether the child has a painful expression. When the right lower abdomen is detected, the child will cry for pain or push it away with his hand; or when the child sleeps, the child will wake up when he touches the pain.

4. Because of abdominal discomfort, the child is not willing to move the right lower limb. Walking, gait instability, claudication and other abnormal performance.

5. Although it is not easy to find the inflamed appendix by B-ultrasound, there is' effusion 'in the abdominal cavity, which can assist in the diagnosis.

Special reminder

Infantile appendicitis should be operated without hesitation

Some parents have doubts about the operation and think it's best not to use the knife when they can be treated conservatively.

However, director Li Dumiao reminded that due to the thin appendiceal wall of infants and the poor ability of limited abdominal infection, these children's appendixes often have distortion, narrow lumen, too long appendix, fecal stone incarceration and other reasons, often within more than ten or even a few hours of appendicitis attack, from simple appendicitis to suppurative appendicitis, then gangrene occurs, leading to appendix perforation It's dangerous. Therefore, in principle, children with appendicitis should not be treated conservatively. If the operation is delayed, serious consequences will be caused.

Early appendicitis, surgery only half an hour, plus now anesthesia is more reliable, surgery is safer.

In addition, appendicitis in girls may lead to tubal obstruction and peristalsis due to pelvic inflammation, which is a cause of infertility in adulthood. Therefore, once the girl was diagnosed with appendicitis, should be active surgical treatment, thoroughly clean up the peritoneal effusion, try not to let the attachment adhesion, so as not to lead to future infertility.