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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
Summary
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.
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