Appendicitis in young children

Bansal S, Banever GT, Karrer FM, Partrick DA. Appendicitis in children less than 5 years old: influence of age on presentation and outcome. Am J Surg. 2012 Dec; 204(6):1031-5; discussion 1035.

In children less than 5 years old with appendicitis, age has a direct correlation to the stage of disease. The youngest children present with more advanced appendicitis but are less likely to develop postoperative abscesses.

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Bagłaj M, Rysiakiewicz J, Rysiakiewicz K. Acute appendicitis in children under 3 years of age. Diagnostic and therapeutic problems. Med Wieku Rozwoj. 2012 Apr-Jun; 16(2):154-61.

1. Acute appendicitis in small children is a diagnostic problem not only for primary health care doctors but also for experienced pediatricians and pediatric surgeons. 2. Early surgical consultation should be a standard procedure in small children with acute symptoms of various locations when there is accompaning abdominal pain, not reacting to conservative treatment. Surgical consultation is also indicated in children under 3 years of age with relapses of abdominal pain. 3. Clinical signs of appendicitis in children aged less than 3 years, may differ from those in older children due to changes in their immunological reactivity. This problem should be included in under-graduate and post-graduate medical studies.

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Rodriguez DP, Vargas S, Callahan MJ, et al. Appendicitis in young children: imaging experience and clinical outcomes. AJR Am J Roentgenol. 2006 Apr;186(4):1158-64.

“The diagnosis of appendicitis in children less than 5 years old can be especially challenging [1-3]. Clinical presentations can be confusing and the diagnosis is often delayed or missed [4], resulting in a higher frequency of complications such as appendiceal perforation [5-7]. In addition, many typical features of appendicitis, such as localized right lower quadrant pain, fever, and leukocytosis, may be minimal or absent in younger children [4].

Sonography and CT criteria for appendicitis have been largely defined in adults and in children without further stratification of patients by age [8-10]. Imaging findings in the high-risk group of young children have not received much attention and are not well described. This study was undertaken to compare the imaging characteristics of younger children (< 5 years old) to those of older children and to determine the impact of a younger age on sonography and CT diagnoses and the clinical outcomes of appendiceal perforation and negative appendectomy rate.”

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Alloo J, Gerstle T, Shilyansky J, Ein SH. Appendicitis in children less than 3 years of age: a 28-year review. Pediatr Surg Int. 2004 Jan;19(12):777-9.

The presentation in preschool children is more often atypical, and tends to be delayed [3, 4, 11], with perforation of the appendix an almost universal finding at laparotomy [3, 4, 11]. This population is often misdiagnosed, and shows greater morbidity [3]. The objective of this study was to review the presenting symptoms and signs, management, and outcome of children under 3 years of age who underwent a laparotomy for appendicitis under the care of a single pediatric general surgeon.

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More PubMed results on appendicitis in young children.

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