Appendicitis is one of the most common acute surgical problems facing children.

• Important DD in children - Mesenteric adenitis

PC

Diagnosis is often made difficult by a presentation which is far from the classically history of:

• central abdominal pain which later radiates to the right iliac fossa
• low-grade pyrexia
• minimal vomiting

Children who are younger or have a retrocaecal/pelvic appendix are more likely to present in an atypical way - may present with vomitting and diarrhoea only

Appendicitis is uncommon in children under 4 years old but in this group often presents with perforation

Investigations

*The clinical diagnosis of appendicitis is usually reliable

Initial investigations:

• Urine microscopy (exclude ectopic)
• ENT examination - If abnormal ?mesenteric adenitis

Management