This finding suggests inflammation has spread to the peritoneum. If the appendix ruptures the pain may disappear for a short period and the child feels suddenly better. However, within a short period peritonitis sets in, the pain returns, and the child becomes progressively more ill. At this time the abdomen may become rigid and extremely tender. Touching the abdomen may cause spasm of the abdominal muscles if peritonitis is developing.
Rectal examination causes pain that is localized on the right side.
Tapping the heels or jarring the leg upwards causes increased pain on the right side of the abdomen. A CBC shows increased white blood cell count . An abdominal X-ray may or may not show signs of appendicitis. The diagnosis may be confirmed by the surgeon during an exploratory laparotomy . Little preparation is required.