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Severe pain after apendectomy, 5 year-old

Hello, my 5 year old boy had an appendectomy 6 days ago and still has very acute pain since the surgery, always around the bellybutton, every 7 hours after intake of medication (antibiotics, painmed) he starts crying so bad that he fallls asleep due his superficial breathing caused by the pain. He can't sit down nor walk without crying due to the acute pain. Eats well, has no fever anymore, but urinates almost every 30 minutes and is then in pain too. Still has a lot of gas and problems to evacuate. Is it the normal appendicitis-surgery recovery process? Or might there be something additional. My mother-instinct tells me he is not ok, despite the surgeon says it's normal. Please help! Thanks!
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replied May 13th, 2011
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I assume he had an open procedure, rather than an endoscopic appendectomy. This requires that the muscles, fascia, abdominal wall, and perotineal cavity lining all be incised. So every time he contracts the trunk muscles (which is about all the time) it will be uncomfortable.

It usually takes about 7 to 10 days for the majority of the significant pain to subside. After that the healing is usually fairly quick. By three weeks, most kids are back to their normal routine, with only occasional discomfort with heavy exertion.

If he is still taking opioid (narcotic) pain medicine, he will have problems with constipation. He may need medicine to help treat that, as straining to go to the bathroom is not only uncomfortable, but puts stress across the incision (which could cause an incisional hernia).

As the bowel starts working again, passing gas is the first sign. For the first few weeks, it is common to have abdominal cramping from the gas. This, of course, can be very uncomfortable. Urinating is a common technique to try to alleviate abdominal pain. At least he is putting out enough urine and he is well hydrated.

You might try a small ice pack on the incision site, if he is having pain there. A heating pad, for a short time, may be more soothing for the abdominal cramping.

Since he is eating well and has no fever, he is most likely right on track. It's hard for a mother to see a child not feeling well. However, most kids will stop eating if there is something significantly wrong. He should start to feel better in the next few days as he has gotten over the first major hump.

If however, he stops eating, develops a fever, has abdominal distention, flank pain, blood in the urine, etc, you should probably speak with his surgeon. And, if you have any concerns, you should contact the surgeon - that's what a mother is supposed to do after all.

Best wishes for your son's speedy recovery. Good luck.
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