Appendix Perforation, Appendicitis in Children – Causes, Treatment

Appendix Perforation, Appendicitis in Children – Causes, Treatment

Appendicitis perforation in children is a condition that occurs when the opening to the appendix gets blocked by bacteria from the intestine, thereby making it swollen and infected. The appendix is a finger-like structure that projects from the colon on the lower right side of the abdomen

It is difficult to differentiate between appendicitis and ruptured appendix in children as they both have similar symptoms. However, this article will help you to know more about perforated appendicitis in your child.

How do you know if your Child has Perforated Appendicitis?

If your child experiences pain in the lower right area of their abdomen, they likely have appendicitis. Your child may have pain around their belly button that moves to their lower right side later. 

They may also experience:

  • A loss of appetite
  • Fever
  • Nausea and vomiting

Causes of Appendicitis Perforation in Children

The exact cause of appendicitis remains unknown, but appendix perforation occurs when an infected appendix is left untreated. However, experts believe that appendicitis occurs due to bacteria blocking the appendix, which then triggers inflammation. 

The intestine consists of beneficial bacteria, which helps break down food material, and harmful bacteria, which causes harm to your body. 

However, when these bacteria accumulate at the appendix’s opening, they’ll reproduce and cause infection. So, if you don’t treat the infected appendix early, it can rupture and cause a hole where dangerous bacteria pass through into the abdomen.

Diagnosis for Appendicitis Perforation in Children

Your child’s doctor will do the following to diagnose them:

Physical examination

Your physician may perform a physical examination on your child’s abdomen to detect the painful area. Your doctor might also request a history of your child’s symptoms after examining the abdomen.

Blood test

In this procedure, your doctor would check for your child’s leukocyte count (white blood cell count). An elevated white blood cell count indicates an infection.

Urine test

Your doctor may also collect your child’s urine and analyze it to confirm if the abdominal pain is caused by a urinary tract infection or a kidney stone.

Imaging tests 

Imaging tests like abdominal X-ray, computerized tomography (CT) scan, ultrasound, or magnetic resonance imaging (MRI) can also be ordered by your physician to confirm if the appendix is ruptured.

Treatment for Appendicitis Perforation in Children

The treatment for a ruptured appendix is the removal of your child’s appendix through an appendectomy. 

Appendectomy is a surgical procedure where a cut is made in the lower right part of the abdomen, and the abdomen is opened. After this, the appendix will be stitched up and removed.

In addition to cleaning off leftover infections that may spread to other parts of the stomach, the ruptured appendix will be submerged in saltwater (saline).

After Surgery

The length of your child’s hospital stay depends mainly on how bad the appendicitis is. It is usually necessary to stay overnight and follow surgery the day after appendicitis has been treated. In some cases, patients may leave the hospital that day.

When a patient has perforated appendicitis, they need to stay in the hospital for at least five days. This will assist in treating the more severe infection and preventing its return.

When your child is hospitalized, they will receive intravenous pain medication and antibiotics.

You can take your child home once they can eat regularly, have no fever or drainage due to the incision, and have normal bowel function.


As said earlier, differentiating between a ruptured appendix and appendicitis in children can be very difficult. However, if you notice any symptoms listed above, you should seek medical attention for your child. 

In addition, if you see any sign of appendicitis, take your child to a physician for diagnosis and treatment before it gets ruptured and infects the abdomen.