12-Year-Old Girl's Stomach Pain Turned Out to be a Common Diagnosis in Kids - Appendicitis
José L. Iglesias, M.D. calls appendicitis one of the great mimics of other conditions such as stomach viruses, flu or strep throat since it doesn’t always follow the rules.
By Heather Duge
Twelve-year-old Adalyn Gibson rarely gets sick. When she fell asleep early one night on the couch, her mom, Chelsey, thought a late night and cheer practice had taken a toll. After vomiting and complaining of a stomachache along with trouble walking, Chelsey made an appointment with the pediatrician. 
“When the pediatrician felt the right side of Adalyn’s stomach, she almost jumped off the table because the pain was so bad,” Chelsey said. “Then she asked Adalyn to jump and when she landed it hurt.”
From a Doctor Visit to the Operating Room
The pediatrician told Chelsey to take Adalyn to Cook Children’s – a place Chelsey had never stepped foot in. A sonogram in the Emergency Department revealed an enlarged appendix. José L. Iglesias, M.D., medical director of Pediatric Surgery, would need to perform an appendectomy on Adalyn that night.
“Everything moved fast – within minutes they were getting her ready for surgery,” Chelsey said. “When I met Dr. Iglesias, he had already done two appendectomies that day. I had complete confidence in him.”
Adalyn’s fear of needles quickly disappeared as soon as the child life specialist worked with her on breathing exercises and distracted her with an iPad. She also felt reassured after finding out how many appendectomies Dr. Iglesias performs each year.
“He took time to listen to me,” Adalyn said. “It was a good experience.”
Dr. Iglesias removed Adalyn’s appendix with minimally invasive surgery by creating an incision in her belly button. Since Adalyn’s appendix had not ruptured, she was able to be discharged and went home the next day. Seven days after surgery, she hiked 5 miles through the Smoky Mountains. 
Signs of Appendicitis Versus a Stomach Virus
Dr. Iglesias said appendicitis is a common diagnosis in the pediatric age group and his pediatric surgery team performs about 900 appendectomies each year. He calls appendicitis one of the great mimics of other conditions such as stomach viruses, flu or strep throat since it doesn’t always follow the rules. If the child experiences a big change in bowel habits or a lot of vomiting, chances are the cause is a stomach virus.
Symptoms of appendicitis:
- Vague belly pain in the middle – in the early stages
- More focal pain – right lower quadrant
- Nausea (as inflammation increases)
- Fever
- Appetite changes
- Pain when moving
Once symptoms begin, the appendix gets more inflamed and bacteria takes over. After about 24 to 36 hours, the appendix can rupture which increases the risk of worsening infection and makes removing the appendix more of a challenge. Once ruptured, IV antibiotics are required for a longer course. 
“It depends on how the body fights it,” Dr. Iglesias said. “Sometimes the body forms abscesses and can turn septic.”
Risks of an appendectomy include infection, bleeding and damage to nearby structures. The risks go up according to the amount of inflammation. Because of the specialists’ experience, the overall risk at Cook Children’s is very low.
A Thriving Teenager
Chelsey said she knew they were at the right place as soon as they walked in the doors. Adalyn is back to her active self with only a few tiny scars. She is an avid reader and actively involved in all sports especially volleyball, basketball and cheer.
“Everyone at Cook Children’s did a phenomenal job,” Chelsey said.
Cook Children's Pediatric Surgery 
When your child requires surgery, you want to be certain that you are receiving the most advanced care possible from the most experienced medical team. The Pediatric Surgery team at Cook Children's specializes in many surgical conditions, from simple to the most complex, and many of these procedures are performed using minimally invasive techniques.
Experience counts, and the pediatric surgery experts at Cook Children's perform more than 3,400 procedures each year on children of all ages. Our surgeons handle a wide range of conditions including congenital malformations, head and neck masses, abdominal and gastrointestinal issues, thoracic issues, tumors and malignancies, and genitourinary surgeries.
Children's bodies are not the same as adult bodies. A pediatric surgeon is specifically trained in caring for patients from birth to young adulthood. When you choose a pediatric specialist, you can trust that he or she understands the very specific needs of a child before, during and after treatment.
Combining experience with compassion, our dedicated team provides high-quality care with the added support of our specialists throughout Cook Children's Medical Center. They work closely with other pediatric experts, like pediatric anesthesiologists, who are dedicated to each child they take care of.
