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Z Oddziału Chirurgii Dziecięcej Wojewódzkiego Szpitalu Zespolonego w Koninie
Med Og. 2009;15(1):11-26
Acute appendicitis is the most common diagnosis in children with a surgical condition of the abdomen. The lifetime prevalence of appendicitis is approximately 7%, with the highest incidence occurring between the age of 10-30. The exact etiology of appendicitis is unknown; however, it is generally agreed that obstruction of the appendiceal lumen is the precipitating event. The obstruction may be a result of an appendicolith or other factors, such as lymphoid hyperplasia, infectious agents, or, rarely, a carcinoid tumour. Children with acute appendicitis present with a wide variety of clinical manifestations, and clinical diagnosis is not always straightforward. Approximately one-third of children with acute appendicitis have atypical clinical findings. Younger children are not able to clearly describe their symptoms. The diagnosis of appendicitis is made by history taking and physical examination. Laboratory test, such as white blood cell count (WBCC), C-reactive protein level, and radiologic tests: abdominal ultrasound scan, focused appendiceal computed tomography with contrast, can be used to support clinical data. Surgical treatment should be performed in almost all cases of acute appendicities in children (appendectomy by an open or laparoscopic). Some cases of performed appendicitis may be treated first by antibiotics, followed by appendectomy.
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