Appendicitis Acute in Children : Triage

Acute appendicitis stands as a predominant surgical emergency within the pediatric population, accounting for 1–2% of pediatric surgical admissions. Among children presenting with abdominal pain, 1–8% are diagnosed with acute appendicitis, though it is notably rarer in preschool children, with only 2 to 9% of cases occurring in this age group. As the most frequent acute surgical condition among children, appendicitis affects roughly 70,000 individuals annually in the United States alone. The condition predominantly occurs in the 12-18 age bracket, with a higher incidence in boys compared to girls.

Although mortality rates are low, the morbidity associated with perforated appendicitis remains significant. The rate of perforation varies from 20-35% among affected children, with the likelihood of perforation escalating in younger demographics, nearing 100% in infants. This high rate of perforation underscores the challenges in diagnosing acute appendicitis in young children, who often present late with severe complications such as abscess formation, generalized peritonitis, and sepsis.

Despite advancements in diagnostic imaging techniques, accurately diagnosing acute appendicitis, particularly in younger children, remains a formidable challenge for healthcare providers

Triage Table for Suspected Appendicitis in Children