Childhood Appendicitis Symptoms Checklist from Johns Hopkins

Doctors recommend that children with prolonged or severe abdominal symptoms that do not go away or improve should be evaluated for ruptured appendix. Consider the following questions:

• Do blood tests indicate elevated white cell count?
• Does the child have diarrhea? Diarrhea, which can be a marker of bowel inflammation resulting from the infection caused by the burst appendix, often distracts doctors and puts them on a different track. Diarrhea may not be a classic sign of appendicitis, but it may signal a ruptured appendix.
• Did the child have vomiting, which later stopped?
• Was there sharp pain in the lower right portion of the abdomen, which later subsided and became dull and spread across the abdominal area? Paradoxically, as appendicitis worsens and the appendix ruptures, the acute pain is alleviated and transformed into more diffuse abdominal pain.