 Introduction/Background Acute abdominal pain is one of the most common presenting complaints to the emergency department for the pediatric population. While the differential diagnosis for acute abdominal pain in children is broad and includes infectious, inflammatory, musculoskeletal, traumatic, gynecologic, and other etiologies, acute appendicitis is an important differential diagnostic consideration because of the potential need for surgical intervention. Acute appendicitis represents in children [1,2]. Approximately 70,000 children per year in the United States are diagnosed with acute appendicitis, accounting for close to 30% of the total cost of all pediatric general surgical conditions combined [1]. The incidence of appendicitis peaks during adolescence and is uncommon in infants and preschool children and rare in newborns [3]. In spite of its high incidence, the diagnosis of acute appendicitis often presents a challenge, as the classic presenting symptoms of periumbilical pain, anorexia, nausea, vomiting, guarding, and migration of pain to the right lower quadrant (RLQ) are not always elicited and are only moderately reproducible between clinicians [4]. Furthermore, these symptoms are less reliable in the pediatric population, particularly those <5 years of age, who more frequently present with atypical symptoms [1]. As a result, presentation and diagnosis may be delayed, which may contribute to a higher rate of perforated appendicitis in the youngest children [5]. While perforated appendicitis tends to be more common in children than adults [6], morbidity is similar to or lower in children than in adults. The most common treatment of appendicitis is appendectomy. In complicated cases of perforated appendicitis with abscess formation, surgery may follow percutaneous abscess drainage and treatment with broad-spectrum antibiotics [2].
Suspected Appendicitis Child.  Introduction/Background Acute abdominal pain is one of the most common presenting complaints to the emergency department for the pediatric population. While the differential diagnosis for acute abdominal pain in children is broad and includes infectious, inflammatory, musculoskeletal, traumatic, gynecologic, and other etiologies, acute appendicitis is an important differential diagnostic consideration because of the potential need for surgical intervention. Acute appendicitis represents in children [1,2]. Approximately 70,000 children per year in the United States are diagnosed with acute appendicitis, accounting for close to 30% of the total cost of all pediatric general surgical conditions combined [1]. The incidence of appendicitis peaks during adolescence and is uncommon in infants and preschool children and rare in newborns [3]. In spite of its high incidence, the diagnosis of acute appendicitis often presents a challenge, as the classic presenting symptoms of periumbilical pain, anorexia, nausea, vomiting, guarding, and migration of pain to the right lower quadrant (RLQ) are not always elicited and are only moderately reproducible between clinicians [4]. Furthermore, these symptoms are less reliable in the pediatric population, particularly those <5 years of age, who more frequently present with atypical symptoms [1]. As a result, presentation and diagnosis may be delayed, which may contribute to a higher rate of perforated appendicitis in the youngest children [5]. While perforated appendicitis tends to be more common in children than adults [6], morbidity is similar to or lower in children than in adults. The most common treatment of appendicitis is appendectomy. In complicated cases of perforated appendicitis with abscess formation, surgery may follow percutaneous abscess drainage and treatment with broad-spectrum antibiotics [2].