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Pediatric appendicitis: Incidence, trends and pathophysiology

Nadeen Alturki1, Shawn D St Peter2

  • 1Department of Surgery, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.

Seminars in Pediatric Surgery
|August 11, 2026
PubMed

Insights

Pediatric appendicitis, a common emergency, is not fully understood. Research suggests it

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Epidemiology

Background:

  • Appendicitis is the most frequent surgical emergency in children and adolescents.
  • Traditional views of appendicitis as solely obstruction-induced are challenged.
  • Significant variations in incidence and severity exist across demographics and geography.

Purpose of the Study:

  • To review current knowledge on pediatric appendicitis incidence and epidemiology.
  • To explore the evolving understanding of appendicitis pathophysiology.
  • To highlight implications for classification, risk stratification, and treatment.

Main Methods:

  • Literature review of population-based studies.
  • Analysis of advances in imaging and microbiome research.
  • Synthesis of epidemiologic trends and multifactorial influences.

Main Results:

  • Appendicitis pathophysiology is multifactorial, involving environment, host, microbes, and healthcare.
  • Uncomplicated and perforated appendicitis exhibit distinct epidemiologic patterns.
  • Incidence and severity show geographic, racial, temporal, and socioeconomic variations.

Conclusions:

  • Pediatric appendicitis is a complex disease with diverse contributing factors.
  • A deeper understanding is crucial for improved clinical management.
  • Future strategies require a multifactorial approach to appendicitis.

Keywords:
EpidemiologyIncidencePathophysiologyPediatric appendicitisTrends

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