[Diagnosis of appendicitis: only experience helps]

Area of Science:

• Medical research
• Surgical pathology
• Pediatric surgery

Context:

• Acute appendicitis presents unique diagnostic challenges in extreme age groups.
• Incidence and complication rates vary significantly across different age demographics.
• Preoperative diagnosis of acute appendicitis remains a clinical hurdle.

Purpose:

• To analyze the incidence and complications of acute appendicitis in pediatric and geriatric populations.
• To evaluate the diagnostic accuracy of clinical signs and patient history.
• To emphasize the role of clinical experience in diagnosing acute appendicitis.

Summary:

• Acute appendicitis is uncommon in children under 5 and adults over 60, but perforation is frequent (40% and 37%).
• In a series of 1456 cases, 11% of acute appendicitis diagnoses were missed preoperatively.
• Classical clinical signs and history are unreliable, highlighting diagnostic variability.

Impact:

• Highlights the increased risk of perforation in young children and elderly patients with appendicitis.
• Underscores the limitations of traditional diagnostic methods for acute appendicitis.
• Stresses the indispensable value of clinical expertise in surgical decision-making for appendicitis.