Appendicitis in children less than five years old:A challenge for the general practitioner

查看全文 作　　者：Pierluigi [1]Marzuillo;Claudio [2]Germani;Baruch S [3]Krauss;Egidio [2]Barbi

机构地区：[1]Department of Women and Children and General and Specialized Surgery,Seconda Università degli Studi di Napoli;[2]Institute for Maternal and Child Health IRCCS Burlo Garofolo;[3]Boston Childrens Hospital

出　　处：《World Journal of Clinical Pediatrics》索引2015年第4卷第2期,共6页

摘　　要：Acute appendicitis is one of the most common indications for abdominal surgery in pediatrics with peak incidence in the second decade of life. Acute appendicitis in the first years of life is an uncommon event. The clinical presentation is often varied and the diagnosis may be overshadowed by other medical conditions.Gastroenteritis is the most common misdiagnosis, with a history of diarrhea present in 33% to 41% of patients. Pain is the most common presenting symptom in children less than 5 years old, followed by vomiting, fever, anorexia and diarrhea. The most common physical sign is focal tenderness(61% of the patients) followed by guarding(55%), diffuse tenderness(39%), rebound(32%), and mass(6%). Neonatal appendicitis is a very rare disease with high mortality; presenting symptoms are nonspecific with abdominal distension representing the main clinical presentation. The younger the patient, the earlier perforation occurs: 70% of patients less than 3 years develop a perforation within 48 h of onset of symptoms. A timely diagnosis reduces the risk of complications. We highlight the epidemiology, pathophysiology, clinical signs and laboratory clues of appendicitis in young children and suggest an algorithm for early diagnosis. 关键词：APPENDICITIS CHILDREN Early diagnosis NEWBORN APPENDICITIS COMPLICATIONS

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Appendicitis in children less than five years old:A challenge for the general practitioner

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