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Appendicitis, Pediatric

Robert J. McLoughlin, MD and Michael P. Hirsh, MD, FACS, FAAP Reviewed 10/2018
 


BASICS

DESCRIPTION

Acute inflammation or infection of the vermiform appendix 

EPIDEMIOLOGY

  • Most common surgical emergency of childhood

  • Incidence rate (per 10,000 person-years):

    • 2 in 0- to 4-year olds,

    • 10 in...

DIAGNOSIS

Classic signs and symptoms include right lower quadrant pain, anorexia, nausea and vomiting, and fever. 

HISTORY

  • Abdominal pain is most common symptom.

  • Pain usually begins in the periumbilical ...

TREATMENT

GENERAL MEASURES

  • IV fluids to correct hypovolemia, electrolyte abnormalities

  • Broad-spectrum antibiotics (e.g., cefoxitin, piperacillin and tazobactam, or ceftriaxone and metronidazole)

  • Pain med...

ONGOING CARE

PROGNOSIS

  • Recovery is rapid.

  • Prognosis is excellent.

  • Overall current survival rate in United States is 98%.

  • It is estimated that 35,000 people die yearly from appendicitis worldwide.

COMPLICATIONS

ADDITIONAL READING

  • Amyand C. Of an inguinal rupture, with a pin in the appendix caeci, incrusted with stone, and some observations on wounds in the guts. Phil Trans Royal Soc London.  1735;39:329...

CODES

ICD9

  • 541 Appendicitis, unqualified

  • 540.9 Acute appendicitis without mention of peritonitis

  • 540.0 Acute appendicitis with generalized peritonitis

  • 540.1 Acute appendicitis with peritoneal abscess

ICD10

  • ...

FAQ

  • Q: What were historical milestones in the treatment of appendicitis?

  • A: Milestones include:

    • 1735: Dr. Claudius Amyand performed an appendectomy in a situation of an appendicitis within a right ingui...

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