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Pediatric appendicitis: state of the art review

Rebecca M Rentea1, Shawn D St Peter2, Charles L Snyder2

  • 1Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas, MO, 64108, USA. rrentea@cmh.edu.

Pediatric Surgery International
|October 16, 2016
PubMed

Insights

Pediatric appendicitis diagnosis and treatment have evolved with evidence-based medicine. Key advances include standardized clinical pathways and selective imaging for diagnosis, and minimally invasive surgery for treatment.

Area of Science:

  • Pediatric Surgery
  • Evidence-Based Medicine
  • Clinical Pathways

Background:

  • Appendicitis is a frequent cause of abdominal pain in pediatric patients.
  • Recent decades show significant shifts in appendicitis diagnosis and management.
  • An evidence-based approach has driven these changes.

Purpose of the Study:

  • To review the current state of the art in pediatric appendicitis evaluation and management.
  • To highlight advancements in diagnostic and therapeutic strategies.

Main Methods:

  • Review of randomized controlled trials.
  • Analysis of large database studies.
  • Synthesis of meta-analyses findings.
  • Examination of current clinical practices in US and European hospitals.

Main Results:

  • Standardized clinical pathways with scoring systems and selective imaging are optimal for diagnosis.
  • Non-operative management is a viable option for select simple appendicitis cases, though pediatric data is limited.
  • Laparoscopic appendectomy is the standard surgical approach in pediatric care.

Conclusions:

  • Evidence-based medicine has transformed pediatric appendicitis care.
  • Current best practices emphasize standardized diagnostic pathways and minimally invasive surgical techniques.
  • Further research is needed to support non-operative management in children.

Keywords:
Abdominal painAbscessAppendectomyAppendicitisChildrenLaparoscopyNon-operative managementPediatricRight lower quadrantScoring system

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