Reasons why children under five are at risk of acute appendicitis with complications

Dr Himawan Aulia Rahman, a member of the Gastrohepatology Coordination Working Unit of the Indonesian Pediatric Society (IDAI), stated that diagnosing appendicitis in young children is more difficult than in older children.

“Acute appendicitis most commonly occurs in teenagers, but uniquely, in children under the age of five, the incidence of complications is more frequent compared to older children,” he said during an IDLE online seminar on Tuesday.

Dr Himawan explained that acute appendicitis is one of the most common causes of emergency digestive surgery. Children under five are generally unable to explain the location and characteristics of the pain they experience.

“However, the unique aspect is that appendicitis in these younger infants more frequently presents with complications. One of the most severe complications of appendicitis is a leak, known as perforation,” Himawan noted.

He explained that diagnosis in young children is more challenging because patients, especially those unable to speak, cannot specify the location or nature of their abdominal pain. Symptoms can also overlap with other conditions, such as gastrointestinal infections or gastroenteritis, constipation, urinary tract infections, mesenteric adenitis, and intussusception.

Doctors are reminding parents to monitor the progression of symptoms, particularly if the pain worsens, is felt in the lower right abdomen, increases with movement or walking, is accompanied by vomiting and fever, or if the abdomen feels very painful to the touch.

“Therefore, it is vital for parents to monitor whether the symptoms of a child suffering from this illness are increasing in frequency or if the intensity is becoming more severe,” he added.