Diagnostic Pitfalls (Appendicitis)

Survey of some reasons why the diagnosis of appendicitis may be difficult in childhood. Infants and toddlers: In infants with clinical signs and symptoms of acute appendicitis similar to a teenager the appendix is already perforated in most cases. Schoolchildren: Stubborn children may dissimulate the pains if a hospitalization is not appropriate for them, or if they are afraid of an operation. In addition, pains during micturation or repeated evacuation of mucus by the anus are often interpreted as lower urinary tract infection or as enterocolitis, but may be due to an appendicitis lying deeply in the pelvis, or a pelvic perityphlitic abscess. Appendicitis combined with oncological diseases is difficult to diagnose; among other things due to diminished immunity, overlapping by side reactions of the treatment of tumor, increased sensibility of the child in case of pain, and consultation by an unknown doctor.