J.Jpn. Surg. Soc.. 121(5): 503-509, 2020

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Feature topic

ACUTE APPENDICITIS

Acute appendicitis represents the most common abdominal surgical emergency in the pediatric age-group. Despite being a relatively common condition, the diagnosis of appendicitis in children can prove to be challenging in many cases. In clinical practice, ultrasound examination is very important in making a definitive diagnosis of pediatric acute appendicitis and stratifying risk. In our facility, we classify the risk into several categories depending on ultrasound findings of the laminar structure and status of blood flow in the appendix. Depending on disease severity, treatments may range from no antibiotic administration to emergency surgery or treatment with antibiotics followed by interval appendectomy. According to the latest annual report from the National Clinical Database, pediatric acute appendicitis is usually treated by general surgeons rather than by pediatric surgeons. Therefore, it is important for all surgeons to understand the clinical features, make accurate diagnoses, and choose the most appropriate treatment for pediatric acute appendicitis.

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