The most frequently encountered surgical problem in the emergency department is the evaluation of abdominal pain to rule out appendicitis. Appendicitis is by far the most common problem requiring abdominal surgery in childhood. Appendicitis in children younger than 3 years is infrequent, accounting for approximately 2% of all cases. The article addresses commonly seen surgical problems that occur in older infants and children with respect to the condition. CLINICAL PRESENTATION Abdominal pain The pain may begin in the periumbilical area or epigastrium.
Usually (but not always) the pain then shifts to the right lower quadrant. Anorexia, nausea, and vomiting may be present but are not discriminating signs. Abdominal pain usually precedes vomiting. Fever and leukocytosis tend to be minimal when the patient presents early in the course of the disease. DIAGNOSIS Physical examination…
