The boy had abdominal pain for several days before hospitalization. His family initially thought it was a digestive disorder and gave him probiotics. The pain worsened, and he became anorexic and had difficulty sleeping. Dr. Nguyen Huu Dung, a pediatric surgeon at Tam Anh District 7 General Clinic, examined him and noted that the patient's abdomen was soft but tender to the touch. A CT scan revealed acute appendicitis, and doctors suspected a rupture at the distal end of the appendix, with multiple abscesses in both iliac fossae.

Doctors transferred the boy to Tam Anh General Hospital TP HCM, where Dr. Nguyen Thanh Son Vu, a pediatric surgeon, performed laparoscopic surgery.

Dr. Vu (right) and his team perform laparoscopic surgery on Tan. Photo: Tam Anh General Hospital

During the surgery, Dr. Vu observed a significant amount of cloudy fluid and inflammatory pseudomembranes in the abdominal cavity. The appendix was inflamed, necrotic, and ruptured at its distal end, with a localized collection of pus around its base. The surgeon used a specialized suction-irrigation tube to clear the pus and inflammatory fluid from the abdominal cavity. After removing the appendix and securing its base, the team repeatedly irrigated the abdominal cavity with a 0,9% NaCl solution until the fluid was clear. The surgical team thoroughly checked the abdominal cavity one last time before placing a drainage tube in the iliac fossa region. The surgery lasted approximately 90 minutes, with no intraoperative complications.

Dr. Vu examines Tan before his discharge. Photo: General Hospital

Post-operatively, doctors closely monitored his pulse, blood pressure, respiratory rate, pain level, and the amount of fluid drained from his abdomen. He continued to receive broad-spectrum intravenous antibiotics to control intra-abdominal infection, along with intravenous fluids for hydration and electrolyte balance, and pain medication.

48 hours after surgery, Tan's bowel movements recovered. Doctors instructed his family to give him sips of sugar water, gradually transitioning to thin blended porridge and milk. Dr. Vu explained that small amounts of sugar water safely restart the digestive system, are easily absorbed, and help assess the bowel's tolerance post-surgery. Tan responded well to treatment and was discharged after 7 days. At a follow-up appointment one week later, he had no abdominal pain, and his incision was dry and healing well.

In children, appendicitis progresses rapidly, and delayed treatment can lead to a ruptured appendix. When this occurs, pus and bacteria spill into the abdominal cavity, causing peritonitis, a dangerous complication of acute appendicitis. This condition increases the risk of severe infection, abscess formation leading to intestinal adhesion, surgical difficulties, prolonged treatment, and other serious complications.

Dr. Vu advises parents not to be complacent if their child exhibits symptoms such as abdominal pain starting around the navel and then localizing to the right iliac fossa, fever, nausea, diarrhea, stooped posture, or reluctance to move due to pain. Children should be taken to the hospital promptly for diagnosis and timely treatment to prevent complications.

Minh Tam

*Patient's name has been changed