CURRENT STANDARDS IN DIAGNOSING AND MANAGING ACUTE APPENDICITIS IN CHILDREN
Keywords:
pediatric appendicitis, acute appendicitis, diagnosis, non-operative management, laparoscopic appendectomy, ultrasound, clinical scoring systems, complicated appendicitis, evidence-based pediatric surgery.Abstract
Acute appendicitis is the most common surgical emergency in the pediatric population and requires prompt and accurate diagnosis to prevent complications such as perforation or abscess formation. Diagnosis in children is often challenging due to atypical presentations, especially in younger age groups, and the limitations of clinical examination alone. Current standards emphasize a structured approach combining clinical assessment, risk stratification using validated scoring systems, laboratory evaluation, and selective imaging—primarily ultrasonography, with CT or MRI reserved for inconclusive cases. Management strategies have evolved beyond routine appendectomy, with laparoscopic surgery remaining the standard for complicated appendicitis, while non-operative management with antibiotics is increasingly accepted for select cases of uncomplicated appendicitis. This review outlines the contemporary diagnostic and therapeutic pathways in pediatric appendicitis, highlights recent trends, and discusses challenges and emerging tools to optimize outcomes.
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