OBJECTIVE To estimate how much of the gap in appendicitis perforation rates between minority and white children is explained by differences in socioeconomic and insurance factors. DESIGN Observational analysis of hospital discharge information. SETTING The Healthcare Cost and Utilization Project database. PARTICIPANTS Appendicitis perforation rates determined from the Healthcare Cost and ...

INTRODUCTION Appendicitis is the most common emergency operation in children. The rate of perforation may be related to duration from symptom onset to treatment. A recent adult study suggests that the perforation risk is minimal in the first 36 hours and remains at 5% thereafter. We studied a pediatric population to assess symptom duration as a risk factor for perforation. METHODS We prospect...

OBJECTIVE Over 9.6 million ED visits occur annually for abdominal pain in the US, but little is known about the medical outcomes of these patients based on demographics. We aimed to identify disparities in outcomes among children presenting to the ED with abdominal pain linked to race and SES. METHODS Data from 4.2 million pediatric encounters of abdominal pain were analyzed from 43 tertiary ...

Despite wide spread availability of sophisticated diagnostic imaging, acute appendicitis in pre-school children remains a diagnostic challenge. Most of these children present late, often with complications e.g. appendicular perforation, abscess formation and peritonitis and as result hospital stay is prolonged and is associated with increased morbidity and mortality.The purpose of this article ...

The diagnosis of appendicitis in infancy is very difficult to make and is thus usually delayed causing complications such as perforation and abscess formation as well as prolonged hospital stays. Though appendicitis in infants and toddlers is a rare happening, it should nevertheless be overseen in children presenting with colicky pain, vomiting (and/or diarrhea), and fever. Delayed diagnosis is...

To date, surgery remains the cornerstone in the treatment of appendicitis. However, recent research has revealed that antibiotic treatment might be an appropriate alternative in selected cases [1,2]. Conservative management with antibiotics causes suppression of bacterial infection by regression of lymphoid hyperplasia. Thereby it might prevent ischemia and bacterial invasion in the early stage...

  Background Recent studies indicate increased serum amylase in children with acute appendicitis. The objective of the current study was to determine the diagnostic accuracy of raised serum amylase level in prediction of perforated appendicitis in children with acute appendicitis. Materials and Methods In this cross-sectional study, 61 children (aged 3 to 15 years) who underwent appendectomy su...

BACKGROUND Cross-sectional imaging increases accuracy in diagnosing appendicitis. We hypothesized that a radiation-free imaging pathway of ultrasonography selectively followed by MRI would not change clinical end points compared with computed tomography (CT) for diagnosis of acute appendicitis in children. METHODS We retrospectively reviewed children (<18 years old) who had diagnostic imaging...

Early diagnosis of appendicitis in infants and children can prevent perforation, abscess formation, and postoperative complications, and can decrease cost by shortening hospitalizations. This article reviews the epidemiology, physiology, and age-specific clinical presentation of childhood appendicitis. The accuracy of diagnostic adjuncts is reviewed, as are strategies for avoiding misdiagnosis ...

INTRODUCTION Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US) or computed tomography (CT) studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modal...