Appendicitis is the most common surgical disease of the abdomen in children. Pediatric appendicitis varies considerably in its clinical presentation, contributing to delay in diagnosis and increased morbidity. The methods of diagnosis and treatment of appendicitis also vary significantly among clinicians and medical centers according to the patient’s clinical status, the medical center’s capabilities, and the physician’s experience and technical expertise. Recent trends include the increased use of radiologic imaging, minimally invasive and nonoperative treatments, shorter hospital stays, and home antibiotic therapy. Little consensus exists regarding many aspects of the care of the child with complicated appendicitis. This article examines the most debated aspects of the diagnosis and management of the diseased pediatric appendix.
aDepartment of Pediatric Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee
bChildren’s National Medical Center, George Washington University School of Medicine, Washington, DC.
Address reprint requests and correspondence: Stephen E. Morrow, MD, Department of Pediatric Surgery, Vanderbilt Children’s Hospital, Doctor’s Office Tower, Suite 4150, 2200 Children’s Way, Nashville TN 37232-9780.
ABSTRACT