Appendicitis
Basics
Description
Acute inflammation or infection of the vermiform appendix
Epidemiology
- Most common surgical emergency of childhood
- Incidence rate (per 10,000 person-years):
- 2 in 0- to 4-year olds,
- 10 in 5- to 9-year olds,
- 15 in 10- to 14-year olds
- 293,000 admissions in the United States in 2010
- 80,000 pediatric appendectomies per year in United States
- Most commonly seen in 2nd decade of life; <5% are aged 0 to 4 years old
- Affects boys more commonly than girls
Pathophysiology
- Acute inflammation of the appendiceal lumen is caused by obstruction (i.e., by a fecalith, calculi, parasites, hyperplastic lymphoid tissue, or tumor).
- Appendix is innervated by somatic afferent nerves of the 10th dermatome overlying the epigastrium and periumbilical areas.
- In the first phase of pain, occlusion causing increasing wall tension results in vague pain poorly referred to this area.
- Increasing wall tension and full-thickness serositis results in inflammation of surrounding tissues, and the second phase of pain is localized to the area in which the appendix is lying.
- In 85% of patients, this tenderness is located at McBurney point; however, pelvic, retrocecal, retroperitoneal, inguinoscrotal, or other orientations will result in variance of location and intensity of this pain.
Commonly Associated Conditions
Neonatal appendicitis is associated most commonly with prematurity, inguinal hernia, and Hirschsprung disease.
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Cabana, Michael D., editor. "Appendicitis." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617106/all/Appendicitis.
Appendicitis. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617106/all/Appendicitis. Accessed November 9, 2024.
Appendicitis. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617106/all/Appendicitis
Appendicitis [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2024 November 09]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617106/all/Appendicitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Appendicitis
ID - 617106
ED - Cabana,Michael D,
BT - 5-Minute Pediatric Consult
UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617106/all/Appendicitis
PB - Wolters Kluwer
ET - 8
DB - Pediatrics Central
DP - Unbound Medicine
ER -