Everybody knows about appendicitis, but it is still a very difficult diagnosis to make in many cases.

Appendicitis is the first concern of parents when a child gets a stomach ache. But other causes, such as viral gastroenteritis and urinary infections, are much more common causes of abdominal pain. Another common problem is swollen glands along the bowel which can be caused by a viral cold or sore throat. These swollen glands can act much like appendicitis, but improve without treatment.

Appendicitis has a few typical symptoms to watch for. It normally begins with pain or an uneasy feeling around the navel. Over a few hours, the pain may migrate to the lower right side of the abdomen. The abdomen gradually becomes quite tender half way between the navel and the front of the pelvic bone on the right side.

The child will usually develop nausea and is likely to throw up. If a child is able to eat, appendicitis is unlikely. There is seldom diarrhea, a symptom that is much more likely to be due to a virus or food poisoning.

As the swelling and infection of the appendix increase, there may be a low grade fever. The blood count is usually moderately elevated. A high fever or a very high blood count is more likely to be due to some other infection.

The main problem with appendicitis is the risk of rupturing which can cause a life-threatening infection in the abdomen. An inflamed appendix can commonly rupture within about 36 hours after the onset of pain, so a person should never delay when appendicitis is a possibility.

When the diagnosis is unclear, a CT scan can be helpful and a repeat exam every six to eight hours may be needed until the cause of the pain declares itself or resolves.

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