Early diagnosis of acute appendicitis in the preschool child and management of the child with peritonitis secondary to perforation are the basic clinical problems of this disease in the childhood age group. Although the mortality over the past three decades has progressively decreased to a very low level, the deaths which still occur are almost exclusively in very young children, diagnosed late and with peritonitis. In addition the morbidity, as reflected in the incidence of complications and prolonged hospitalization, is largely confined to patients with perforation. Diagnosis of acute appendicitis in the young child before perforation occurs can be improved by careful and thoughtful appraisal of the child with abdominal symptoms, by hospitalization with frequent evaluation of patients in whom the diagnosis is in doubt, and by expert interpretation of abdominal x-rays in such patients. Successful management of seriously ill children with perforation and peritonitis depends on intensive treatment to
BOLES ET, IRETON RJ, CLATWORTHY HW. Acute Appendicitis in Children. AMA Arch Surg. 1959;79(3):447–454. doi:10.1001/archsurg.1959.04320090095014
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