Appendicitis: The Ins and Outs
Appendicitis is a complicated condition. While the cause of appendicitis is relatively unknown, it is critical that it's caught before it progresses, potentially causing the appendix to burst.
A recent study looked at the use of antibiotics in uncomplicated cases of appendicitis in children as a potentially better option than surgery for some kids.
UR Medicine pediatric surgeon Dr. Christopher Gitzelmann believes more research is needed in order to make a definitive decision. However, he cautions that avoiding surgery in the beginning could lead to more complicated issues in the long run.
Health Matters: What is appendicitis and what symptoms should parents watch for?
Gitzelmann: Appendicitis is when the wall of the appendix, a 3.5-inch-long tube that extends from the large intestine, becomes inflamed and fills with pus. The goal is to catch it when it’s acute, before it transitions to perforated appendicitis, which can cause sepsis and be fatal.
Symptoms typically include a consistent pain in the right lower quadrant of the abdomen, a fever, and a loss of appetite. The difference with a viral stomachache is that the pain is crampy, whereas the pain from appendicitis doesn’t go away.
Health Matters: What is your protocol when you see a child come in with appendicitis?
Gitzelmann: With the cases I’ve done, it’s just an overnight stay and the patient is home the next day. We administer antibiotics to prevent inflammation from progressing and schedule surgery within a few hours of when the patient is first seen.
Health Matters: Do you believe an antibiotics-only route is a safe option?
Gitzelmann: Nobody knows, at this stage of research, if having an inflamed appendix will mean having a reoccurrence of inflammation. With that, there isn’t a real benefit of just giving antibiotics if, in the end, the appendix still has to be removed.
Christopher Gitzelmann, M.D., is an associate professor of pediatric surgery at UR Medicine’s Golisano Children’s Hospital.