Paediatric appendicectomy

Removal of the appendix in children with appendicitis, most often performed by laparoscopy for a rapid recovery.

What is it?

Acute appendicitis is one of the most frequent surgical emergencies in children. It corresponds to inflammation of the appendix, a small segment located at the beginning of the large intestine, and typically presents with abdominal pain, fever and loss of appetite. Treatment consists of surgical removal of the appendix. In children, the procedure is most often performed by laparoscopy, through very small incisions, which limits post-operative pain and allows a rapid return to normal activities. A short conventional incision remains possible depending on the situation. At Clinique Pasteur Tunis, appendicitis in children is managed without delay, from arrival at the emergency department to the operating theatre, by a paediatric surgery and anaesthesia team. The hospital stay is short and parents are involved at every step.

When is it indicated?

Acute appendicitis confirmed by clinical examination and imaging

When the appendix is inflamed, it must be removed promptly to avoid complications; the procedure relieves the child within the first few hours.

Right lower abdominal pain with fever in a child

Pain in the lower right side of the abdomen accompanied by fever raises the suspicion of appendicitis and warrants a consultation without delay.

Complicated appendicitis (abscess, peritonitis) requiring urgent treatment

When the infection has spread within the abdomen, urgent surgery combined with antibiotic treatment brings about recovery.

Persistent diagnostic uncertainty justifying laparoscopic exploration

When tests cannot settle the diagnosis, a camera exploration through small incisions confirms the diagnosis and treats the problem at the same time.

Preparation

1Assessment in the emergency department: clinical examination, blood tests and abdominal ultrasound

2Fasting from the moment the diagnosis is suspected

3Intravenous fluids and antibiotic treatment started before the procedure if necessary

4Anaesthesia consultation carried out as an emergency

Procedure

General anaesthesia adapted to the child's age

Introduction of a camera and fine instruments through small incisions

Exploration of the abdominal cavity and confirmation of the diagnosis

Removal of the appendix and washing of the cavity if needed

Closure of the incisions with absorbable sutures

Monitoring in the recovery room, then a short hospital stay

Duration

45 minutes to 1 hour 30 depending on severity

Aftercare & Recovery

After a straightforward appendicectomy, the child resumes eating quickly and generally goes home within 24 to 48 hours. In cases of complicated appendicitis, the hospital stay is slightly longer to continue antibiotic treatment. Return to school usually takes place within a few days.

Risks and side effects

Wound infection, uncommon and easily treated

Residual intra-abdominal abscess in cases of complicated appendicitis, monitored and treated if needed

Temporary abdominal pain related to laparoscopy

These risks remain rare. Your surgeon will inform you in detail before the procedure.

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At a glance

Duration: 45 minutes to 1 hour 30 depending on severity

Preparation: Required

Dedicated specialist team

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