Appendicitis is a common cause of pediatric abdominal pain, but the evaluation of abdominal pain in children can be quite difficult because the symptoms are very vague.
According to a new study led by the Johns Hopkins Children's Center, many American children suffer a ruptured appendix, a life-threatening complication because younger children have fewer classic symptoms of nausea, vomiting and pain in the abdomen making it easy to miss the diagnosis.
The researchers reviewed the frequency of the most common symptoms of actual appendicitis in children by analysing 25 studies and identified some of the most telltale signs that will help doctors to narrow down the diagnosis and prompt them to refer the child to a surgeon for evaluation.
These include "rebound" tenderness or pain that occurs after pressure is removed abruptly from the lower right abdomen; abdominal pain that starts around the belly button and migrates down to the right and an elevated white blood cell count. They also suggested that CT scans should be avoided if possible.
The study is published in the July 25 issue of JAMA. 2007;298:438-451. Read the abstract.
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