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Updated: Jan 20, 2026
Appendicitis-II: Diagnostic Studies and Management
Acute appendicitis in children under 4 years:a diagnostic dilemma
Ricardo Rassi1, Florencia Muse, Eduardo Cuestas
1Hospital Privado de Córdoba. ricardorassi@hotmail.com.
Insights
Acute appendicitis in young children (<4 years) often leads to perforation due to non-specific symptoms. Early detection of pediatric appendicitis remains challenging, increasing complication risks.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Pathology
Background:
- Acute appendicitis involves inflammation and potential perforation of the cecal appendix due to lumen obstruction.
- In children under 4 years, appendicitis frequently presents with unspecific symptoms, leading to delayed diagnosis and high perforation rates.
Purpose of the Study:
- To conduct a literature review on acute appendicitis in children under four years old.
- To investigate current knowledge regarding appendicitis in this specific pediatric age group.
Main Methods:
- Systematic bibliographic search of the PubMed database.
- Literature review covering publications from 1980 to 2017.
Main Results:
- Children under 4 years exhibit a high incidence of appendiceal perforation at diagnosis.
- Unspecific clinical presentation contributes to a low index of suspicion and increased complications in this age group.
Conclusions:
- Increased morbidity in pediatric appendicitis (<4 years) stems from age-related factors, diagnostic delays, and complicated disease forms.
- No single sign, symptom, or combination reliably enables early detection of appendicitis in children under 4 years.
Introducction:
Acute appendicitis is a pathology caused by inflammation of the cecal appendix , due tocthe obstruction of the appendicular lumen,witch leads to a venous congestion and then eventually to an arterial compromise of the appendicular wall with the consequent perforation of it.The main problem of this pathology in children under 4 years is the high index of appendicecal preforations presented by patients at the time of diagnosis,mainly driven by an unspecific clinical presentation,which leads to a low index of suspicion and a high percentage of complications in that age group.
Objetive:
perform a literature review on the subject and investigate what is known of appendicitis in children under four years old to date. The data were obtained through a systematic bibliographic search in the pubmed data base from 1980 to 2017
Conclussion:
Conclussion the increase in morbidity of acute apendicitis in children under 4 years has a mixed origin since organic factors are mixed age,together with a temporary diagnostic delay and with it the appearance of complicated forms of the disease, there is no sign,symptom or group of them that allows early detection of appendicitis in children under 4 years of age.
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