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 Vol. 18 No. 1, July 2007
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AAP Grand Rounds 18:3-4 (2007)
© 2007 American Academy of Pediatrics

EMERGENCY MEDICINE

Pediatric Appendicitis: Typical and Atypical Presentations

Source: Becker T, Kharbanda A, Bachur R. Atypical clinical features of pediatric appendicitis. Acad Emerg Med. 2007;14:124–129; doi:10.1197/j.aem.2006.08.009[CrossRef][Medline]

The first 20% of the full text of this article appears below.

The classic description of appendicitis includes the onset of periumbilical pain followed by nausea, then migration of pain to the right lower quadrant (RLQ) and finally, vomiting and fever. However, this progression of symptoms is less common in children than adults.1 Absence of classic symptoms leads to a higher rate of appendiceal perforation in children.2,3 Increased morbidity as a result of diagnostic delays in cases of appendicitis is a common cause of malpractice suits.4 To determine the frequency of atypical clinical features among pediatric patients with appendicitis, researchers from Children’s Hospital Boston and Morgan Stanley Children’s Hospital of New York enrolled children between 3 and 21 years of age with suspected appendicitis over a 20-month period. Standardized data collection forms were completed by the fellowship-trained pediatric emergency physician responsible for the care of the patient. These forms were completed independent of surgical evaluation and prior to diagnostic imaging. Patients were excluded if they were pregnant, or had a history of prior abdominal surgery, chronic medical conditions, or a radiologic study within the prior two weeks. Data were collected on 24 demographic, historical, and physical examination variables. Laboratory, pathology, and operative . . . [Full Text of this Article]

Ronald I. Paul, MD, FAAP
Pediatric Emergency Medicine, University of Louisville, Louisville, KY

 



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C. M. Cavett
Outcome of Laparoscopic Appendectomy for Perforated Appendicitis
AAP Grand Rounds, October 1, 2008; 20(4): 44 - 44.
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