30 answers

How Do You Know If a 4 Yr Old Has Appendicitis?

Before I start, I want you all to know that I talked to a nurse last night and will be getting my son to the doctor today. I was hoping that someone might have some advice for me before I go to the doctor and maybe some insight on their own experiences with their children. If you've had a young child go through appendicitis, I would love to hear from you about what you remember about the experience before they were diagnosed and what advice you might have for questions for the doctor. Here's what's happening with my little man. On Sunday, he threw up 2 times in the morning and then ran around as if nothing was wrong. Two hours later he was snuggled up with me and lethargic and saying that his tummy hurt and this was 2 hours before his nap (I know, he's 4 and still naps?!?!?). So, he took a nap and was fine afterwards and for the rest of the night. He seemed fine yesterday morning. My sister-in-law watched him and she said that he was curled up on the couch crying for about 15 minutes but told her to "go away" and didn't want her to come by him. Last night he said his tummy hurts "right here" and pointed to the right side of him tummy. He seemed fine for about an hour and then said "mommy I'm going to go lay down so my tummy feels better" and then was up and running again within a few minutes. Also, he's been off of pull ups since his 3rd birthday which was over a month ago. He was doing great and first during naps and bedtime, but now seems to be having more and more accidents. So, we've had the lethargy, pain in the right side (none in the left), vomitting and nausea. He hasn't had issues with pooping or a fever and it's all so weird because he's fine one minute and then tired and nauseated the next. I thought that if it in fact was appendicitis that it would hurt all of the time. Help. Has anyone gone through this? Am I crazy thinking that it could be appendicitis?

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So What Happened?™

Oh my gosh....I am completely overwhelmed with all you mommy's out there and your responses to our situation. AMAZING!!! I have never done a blog posting before this incident, but I will if I'm concerned about something again. THANK YOU ALL SO MUCH! So, here's the final situation on what happened with my little man. As an FYI, during the time I was concerned he did not have a problem pooping and didn't have a fever. His accidents have been pee pee's and occur during nap and bedtime on occasion (it seems like a lot more lately and this I'm thinking is a coincidence). After I posted on mamasource, I hit the web and did a little research and to my surprise everything seemed to add up to Appendicitis with the exception of the poop. But, after reading all of your "real life" situations, I can now say it wasn't. Primarily because he was fine at times. It sounds as though with appendicitis you are pretty immobile and in excruciating pain. Also, the next morning I had him do the jump test off of our kitchen chair and he was fine. His tummy hurt a "little bit" that day, but by lunch time he said his tummy didn't hurt anymore so I cancelled my appointment and vowed to keep a real close eye on him and he's completely back to normal. Now, here's the kicker...my sister-in-law called me last night and my nephew is having the same symptoms, including the fact that only the right side of his tummy was hurting. So, it appears as though we have some strange flu virus going around...beware. Thanks again to all of you amazing mommy's that are just trying to help a "sister" out!!! You Rock!

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Hi I my sisters little boy had appendicitis when he was 4. His temp was up and he was throuwing up. His blood cells was up high. I think it was the white cells. He was in the hospital for a week. I hope everything goes ok for you. lc

My son (5) just went through this and I actually thought that it could be appendicitis as well. I took him to the dr. and he had an ear infection and a cough/cold/virus. I really wouldn't have thought that it could be an ear infection until he started complaining about his ear. The day or so before he was complaining about his right side and, like you said, one minute would be up running around and the next minute he would fall asleep on the couch (he doesn't take naps, so this was unusual). My neighbor suggested I take him to the dr. for the ear infection b/c her kids get them a lot and they complain of body aches and they are lethargic. Hopefully that is all it is....

HI S. I remember my sister she was 5 years old, lots of green vomitting, and she could not even walked. She always complained about her leg and tummy. If it is aphandex he should be more comfy while he pulls his legs to his tummy.

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I think it COULD be appendicitis, but is there any possibility he is a little constipated? That would cause right-sided pain. Also, if he had a little bug that was causing some stomach upset that may also cause pain in the right side and of course vomiting.

Also, a urinary tract infection could potentially be the cuprit, especially if his accidents are pee. I would expect a fever but not necessarily in every case. UTIs and constipation tend to be more common in kids who have just potty-trained due to nervousness or fear.

Definitely see the doc, but rest assured that appendicitis is relatively rare in young children and usually gets acute fairly quickly, so this is probably something else. Good luck. (by the way I am an RN but NOT in pediatrics so far from expert.)

My son was 3 1/2 when on a Saturday evening he began throwing up. He slept with us and didn't complain too much of stomach pain, but threw up off and on through the night. Sunday morning he got out of bed, stood up and immediately crumpled onto the floor in so much pain he couldn't stand. We went to the emergency room and after much testing he was in surgery by 2 pm.

They did so much testing because appendicitis is so uncommon in small children and they wanted to be sure. Luckily the doctor (and I) had a hunch from the beginning because all the symptoms fit. She said that the appendix often does perforate in children because it isn't caught in time.

The surgery was laproscopic, took only about an hour and left three tiny scars (one of which is in his belly button). He was up and playing by the next day.

Good luck to you and your son. Go with your instinct because a mother knows when something isn't right with her child. We'll be thinking of you today and please let us know what happens.


I am glad you are going to the doc and hopefully you will be able to figure it out. My daughter went through this experience about 6 months ago. She is also 4. They made her do a simple test, that you can do, to see if he has appendicitis. The simple test is having him jump in place. Crouch down and then jump. If he doubles over in pain, then you have a problem. If he does not it could be simple gas pain. My daughter passed the jumping test. She ended up having a urinary tract infection. Your son may have irritable bowl syndrome as well.

Good luck at the docs and I hope he feels better soon!

You mentioned that your son's poop was okay inspite of vomiting. When was his last BM? Was it normal? Hard? Is the pain upper or lower right side? When you palpate the area does it get worse when you withdraw your hand? When you say he has accidents is it just with urine? Is he better after he urinates? Abdominal pain is difficult to diagnose. Could it be appendicitis? Maybe, obstruction, maybe. Continue to monitor his temp and in and outtakes.
This is one to be seen by your pediatrician. Appendicitis is usually diagnosed with WBC count and or ultrasound.
Good luck. Let me know the outcome. P. H

I had an appendicitis flare-up when I was 15.I know this is slightly different than your request.But over the years I have shared the info it is simmilar in how it shows-up.I was fine all day,went to the movies with friends had popcorn and pop then all of a sudden I ran to the bathroom to throw-up! I mean from the bottom of my feet throw-up!!I told my freinds they got me home and I proceeded to vomit all night,just as violent as the fist time but by the 3rd time I had nothing left inside.I then began to throw-up stomach bile-green in color.I went to the doctor the next day and simple urin test proved that my appendix was leaking and ready to burst.Emergency surgury and I was as good as new.Oh yeh no other obvious physical feelings-fever,conjestion,coughing.sneezing-nothing but violent vomiting. Good Luck!

I know this sounds crazy, but ask him to jump! Yes jump!
If he can't jump, it's appendicitis. If he can just jump, in the air, then it's not.

For my son, it was. It is what my pediatrician told me to do before I met him at the hospital.

Good Luck

Well first of all no you are not going crazy. I have gone through what you have gone through as well only it ended up being (believe it or not, backed up stool). I took my son for the same symptoms you had (my co-worker also had the same problem and she ended up having backed up stool as well) and we have him a ct scan as well and it ended up being backed up stool. I was concerned because appendicitis runs in my family and now it has slowly trinkled its way down to my nephews as well (my three brothers and father had to have theirs removed). So please check out every option before going under the knife, but don't wait too long because it could be fatal.

Good luck!

My son (5) just went through this and I actually thought that it could be appendicitis as well. I took him to the dr. and he had an ear infection and a cough/cold/virus. I really wouldn't have thought that it could be an ear infection until he started complaining about his ear. The day or so before he was complaining about his right side and, like you said, one minute would be up running around and the next minute he would fall asleep on the couch (he doesn't take naps, so this was unusual). My neighbor suggested I take him to the dr. for the ear infection b/c her kids get them a lot and they complain of body aches and they are lethargic. Hopefully that is all it is....

take him to dr i had mine out when i was 6 sounds suspicios to me better to be safe then sorry my burst on the operating table,god must have been watching over me.J.

I have 3 daughters who all had there appendics out, my oldest got sick on Thanksgiving with throwing up she had a fever and her stomach hurt. you need to check his stomach in the middle press down and see if the pain goes to the right side. Take him to the doctor as soon as you can,You don't want it to burst.

When I was in second grade I had my appd. removed. I can remember the event as if it was yesterday (30 years ago). I walked home from school (my mom couldn't be reached b/c she was outside and we only lived 3 blocks from school...can you imagine that happening today?!) Anyway - I road my bike that day and my stomach hurt so bad that I couldn't ride it so I had to walk. When I got home I started to throw up - everything from sprite, pepto, anything they gave to help calm my stomach came up instantly. I started to run a fever and my parents rushed me to the hospital. I'm not a doctor so I don't know if everyone has a different experience...this was mine. I hope he's feeling better!

Hi S.. I am almost 50 years old and had my own appendicitis attack when I was 10. I remember it as if it were yesterday! The symptoms do sound like it could possibly be appendicitis.
It is very painful and the pain can be sporadic.
Definitely take him to the doctor. If overlooked and if the appendics should burst it is very serious and possibly fatal.
When I was in the hospital (back in 1968!) my roommate was a 4 year old boy coincidentally. His appendics had burst and he was a very sick little boy. It may be that he's regressed with potty training because it hurts. Hope all goes well--always better to err on the side of caution. Good luck! Let me know when things calm down!
P.--Mom of 4--1 is a childhood diabetic

it is very important to take your child to the er right away.if it is an appy it could perforate and become much more serious. the symptoms sound right on. I actually diagnosed a friend in California over the phone with the same thing and she went to the er and sure enough. caught it just before it perforated.I am a medical assistant and work for 4 surgeons. good luck

Hi I my sisters little boy had appendicitis when he was 4. His temp was up and he was throuwing up. His blood cells was up high. I think it was the white cells. He was in the hospital for a week. I hope everything goes ok for you. lc

S. Good choice you made. Doing the jump test was a good idea. Your absolutely right you are immobile and in excruciating pain. I was 7 (second grade) when I had my appendicitis and I could not stand up straight at all. I never threw up and had to be carried by my mom to the car to the hospital. I was put on antibiotics and the inflamation went down. Back then hey did not want to do surgery because I was so young. That was 33 years ago.

It's funny but I had the same thing happen to my son (he was 8 yrs old) and the Docs kept telling me that it WASN'T appendititis ~ he was just consipated. Kids that young do not have appendix problems ~ it usually happens in there teens, so they say! They sent him home and it got worse ~ the following morning he had to have ER surgery to have his appendix removed.

They say if the kid can't hop or squat it's his appendix ~ if he can't bend and touch his toes and I also hear that he can't lift his leg.

My oldest son has consipation problems and always has pain on his right side ~ to date it's never been his appendix.

You can always go to WebMD and read more information.

Good Luck!

You're not crazy mommy, just scared. I had an appendiditis attack when I was a teen. I was shopping with my parents and suddenly bent over a yelled "MOM". That fast I blacked out and hit the floor. When I came too, the dr. was at my side and I was on my frontroom couch at home??? How I got there, I don't know. I did have appendicitis but was treated with some kind of medicine and was made to rest for the whole weekend (forever for a teenager). After that, I didn't need the surgery and I've never had it again. Hang in there mom.

Responce is late but I'm sure your son has had a blood test to determine the count of his white blood count. In the field we would check marines to determine on physical assessments if they had appendicitis is having the marines stand on their tippy toes and pounce on their heels and if they had extreme pain it was likely possible or they just were backed up. But its hard when they are four and I'm not a doctor.

My mother-in-law had two children that had appendics actually to burst. My husband when he was in highschool and one of her youngest twins when she was about seven. She said that both started running a high fever and were in excrutiating pain and she had to rush them in.

My five year old has been complaining off and on for three or four weeks about her right side hurting. She had the flu in the beginning and got very dehydrated. She threw up one time, had diarreah once or twice, but then started hallucinating so I took her to the emergency room where she was put on an IV. I got her home and for almost a week I had to keep her on Ibuprofen for a 102 to 103 fever...tylenol wouldn't make a dent.

Then her fever seemed to break for four or five days. But then out of the blue it started back and she really complained that her side was hurting. My husband got worried because he had the appendics thing. He took her back and they told him it wasn't appendics and they couldn't find anything virul either. So I took her to the pediatrician a week later. She checked out fine. But she still complains her side hurts from time to time. They did urine tests at the hospital twice and again at the doctor's office and nothing with the kidneys either.

If you find out something, please let me know. I worry that it is something they are missing. She doesn't drink enough fluids unless I force her to finish her milk, juice and water with her meals. She also holds her pee all day unless I make her go sit on the potty. I watch four all day long and sometimes I'm not as vigilant with those things as I should be.

If you find out anything and would like to share please email me ____@____.com


With an appendicitis, the kids generally don't want to run around. Could be a bladder infection boys can get them too. Could be just a stomach flu. If you have ever had cramps with the stomach flu, he mey be experiencing this. Best to follow up with your pediatrician. Good luck.

I would think with appendicitis there would be severe pain and fever. My children have never had it but husband did when he was younger and someone at work just hadit last month and those were their syptoms. I do know there is a flu going around, which I just so happen to have caught and over the weekend I experenienced major body aches and fever but then when the fever broke I felt fine, but then would get very tired and still am very tired as I go about the day. I had no vomiting or poop issues either. God Luck at his sppoitment today and hoefully they will have some answers for you.


Be careful with this one...my girl was 3 when I thought she was having a appedicitis...but it all happen in one night and when I took her to the ER they said how unlikly but when they got the white cell count back they were about ready to schedule her for surgery.

THANK GOD my ped. office called and said to do an XRAY of her chest - and she didnt have Appendicitis but pneuomia (?) - they reason little kids stomachs hurt is that because of their size their lungs can touch their stomach.

Please have an xray of his chest - and I would get him in right away

Good luck!

Not sure if it is appendicitis. I had my appendix taken out when I was 11 years old. It hurt so bad all the time that I couldn't even stand up straight, so when I walked I was curled over. I vomited constantly, could not eat, had a fever, no bowel movements and was just in a lot of pain. When my mother first took me to the hospital they said it was a bladder infection (IDIOTS....I had a bladder infection before and my symptoms were nothing like it). When it got worse, my mother decided to take me to a different hospital. Yup, they had to rush me into emergency surgery on Thanksgiving Day, because it was rupturing. I was in the hospital for 1 week on antibiotics clearing the infection. Definitely get it checked out.

HI S. I remember my sister she was 5 years old, lots of green vomitting, and she could not even walked. She always complained about her leg and tummy. If it is aphandex he should be more comfy while he pulls his legs to his tummy.

Yep.....appendicitis. My son came home from school a couple years ago with the same complaint. his pain threshold is ridiculously high so I kept a pretty close eye on him. He also wanted to lay down till his tummy felt better. I took him to the doc 2 hours later when the pain got intense and his fever spiked. The doc called the er and the surgeon from his office and my son had an emergency appendectomy in a matter of a couple hours. By that time, his appendix had ruptured and he had peritonitis so badly that they were pouring antibiotic iv fluid directly into the incision. He was in the hospital for 4 days because the infection would not go away. Good Luck

Hi S.,

I only skimmed the responses so I apoligize if this has been mentioned already. Have the Dr. check for Strep throat. It took two emergency room visits to diagnose my 5 yr son. Turns out that when he gets strep throat, he gets stomach pains. No sore throat, no fever and only vomits occasionally. He acts the same way you described. It's intermittenet, but usually worse in the evening. Hopefully your son's is no more serious then strep.
Good luck.

I agree that it could be an intestinal thing causing the pain... that being said, I recently went to the hospital for lower right abdominal pain, vomiting (without a sour stomach - the vomiting was caused by the excrutiating pain I was in) and without a fever... (did I mention I was 35 weeks pregnant). I had previous 'bad' episode that spontaneously went away while I was in the ER. I would get periodic episodes for a few minutes here and there that would also go away on their own. my condition ended up being ovarian torsion. now I know your son cannot have that, but it is possible for other organs to twist like that, causing pain, that will stop if the organ untwists; gall bladder, kidney, appendix...

By the way, they did not diagnose my problem - they only discovered it because I ended up with an emergency c-section that night and my OB discovered it during surgery. I dont know how long it would have taken to get the correct diagnosis....

my advice for you - ask for an ultrasound on your son BEFORE surgery if possible...

good luck - I hate when my kids are not well...

p.s. - I edited for the many spelling errors I had... guess I should wait until my morning coffee to kick in before posting, huh? :-)

my son had a appendicitis when he was five he was crying about pain on right side and was vomiting floresent green i took him to the care station and all the doctor did was to raise his right leg and my son could not do it they called the ambulance and we were in surgery within 30 min it was a quick surgery and recovery.i hope everything is ok.good luck

Usually would be w fever and more acute and increasing in intensity. Unless it is a more gradual type. I had a severe case when I was a child and my brother had one a few years ago. One thing that I know is if you lift your son's knees up to his chest when he is laying down that would make it hurt worse and if it gets bad it would be hard to walk standing up straight. He would be hunched over in pain. If he has any extreme thirst you may think about diabetes as well.

S., as a Peds nurse, i have seen kids enter the unit with appendicitis and act better than your child seems to be. There is no 100% way of knowing, MD's typically go by presentation of pain (they do some little manuvers where they bump the bottoms of their feet and see if the kid complains of pain in that lower R quad- it indicates peritoneal pain), white count, fever, etc..But, there is no 100%. Flu can also act this way, too. So, really nothing except watching and waiting sometimes is necessary. Flu can mimic appendix and vice versa. I suppose if you are determined that it might be that, you could ask for a CT of the abdomen, but that is very pricey and may not be covered by your insurance because they may not deem it necessary. And, frankly, I have seen CT's be normal, the fevers continue, they operate and it was bad..so CT's arent 100 percent either. I would prob. watch it, maybe check a white blood count on a CBC and watch for fever. ALso, the best sign as far as cheap is the various methods that they go to ilicit peritoneal pain (the heel bump; they also sometimes bend the knee while they lay on their back and cross their leg to touch their other leg, same deal, brings on pain in a certain area usually). It is quite frustrating, i know, let us know what happens..

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