Appendicitis in children

Question 1

Causes of appendicitis in children

Answer 1

Most common cause of abdo pain over 3y/o

Faecolith (hard stool stone) most common in pre-school children -seen on Axr

perforation more common

Question 2

Signs and Sx of appendicitis in children

Answer 2

Difficult because signs are not always the classic

Umbilical pain migrating to RIL. -worse with movement
Constipation
Fever
Minimal vomiting but nausea
Complete loss of appetite
Withdrawn/quiet/tired

tender abdo 
Obtuator/psoas signs
Rosving sign (pressing LIL pain in RIL)

children also perfore faster -peritonitis

Question 3

Ix of appendicitis in children

Answer 3

FBC, Pregnancy test (age/gender depending)
CRP, 
Urine dipstick
Clinical observation
AXR +/- USS, CTAP, MRI

Question 4

Management of appendicitis in children

Answer 4

GAME 
G&S
Iv Abx
MRSA screen
NO eating and drinking (NBM)

appendissectomy