Appendicitis

Question 1

Appendicitis is inflammation of the appendix.

It is rare in <5yrs but if present, perforation rates are high in this group.

Answer 1

Appendicitis is one of the most common acute surgical emergencies in children.

Question 2

Diagnosing appendicitis is difficult due to atypical presentation in children.

How does appendicitis present in children?

Answer 2

History suggestive of appendicitis:

1. Central abdominal pain which later radiates to the right iliac fossa
2. No previous episodes
3. Anorexia
4. Minimal vomiting
5. Absence of cough / polyuria

Examination signs:
1. Fever and tachycardia

If the child appears well, can sit forward unsupported and hop => appendicitis is less likely

Question 3

Children who are younger or have a retrocaecal/pelvic appendix are more likely to present in an atypical way

Answer 3

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