What About Kids and Appendicitis? Small Adults or Different Approach?
Appendicitis diagnosis in children is challenging. Atypical features are common. Less than half of children will present with classic periumbilical pain migrating to the right lower quadrant. Misdiagnosis rates are high. Perforation risk rises linearly and substantially with time. Clinical decision rules have been developed to aid in diagnosis but have limited utility due to inadequate positive predictive value. Ultrasound is the preferred initial imaging modality in children. Transfer to a pediatric center should be considered before imaging is conducted due to the complex clinical decision-making that may occur with an equivocal ultrasound. Appendectomy is the mainstay of treatment.
KeywordsAppendicitis Child Children Pediatric Right lower quadrant Fever Pediatric Appendicitis Score Ultrasound CT MRI