Pediatric Surgery International

, Volume 33, Issue 3, pp 269–283 | Cite as

Pediatric appendicitis: state of the art review

  • Rebecca M. RenteaEmail author
  • Shawn D. St. Peter
  • Charles L. Snyder
Review Article


Appendicitis is a common cause of abdominal pain in children. The diagnosis and treatment of the disease have undergone major changes in the past two decades, primarily as a result of the application of an evidence-based approach. Data from several randomized controlled trials, large database studies, and meta-analyses have fundamentally affected patient care. The best diagnostic approach is a standardized clinical pathway with a scoring system and selective imaging. Non-operative management of simple appendicitis is a reasonable option in selected cases, with the caveat that data in children remain limited. A minimally invasive (laparoscopic) appendectomy is the current standard in US and European children’s hospitals. This article reviews the current ‘state of the art’ in the evaluation and management of pediatric appendicitis.


Appendicitis Appendectomy Scoring system Laparoscopy Abscess Children Pediatric Non-operative management Abdominal pain Right lower quadrant 



Appendicitis inflammatory response


Body mass index


Confidence interval


C-reactive protein


Computed tomography


Emergency department


Gut-associated lymphoid tissue


Intensive care unit


Interventional Radiology


Length of stay


Likelihood ratio


Magnetic resonance imaging


Negative predictive value


National Surgical Quality Improvement Program


Perforated appendicitis


Pediatric Appendicitis Score


Pediatric Health Information Systems


Positive predictive value


Randomized controlled trial


Surgical site infection




White blood cell


Compliance with ethical standards

Conflict of interest

The authors have no disclosures or conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Rebecca M. Rentea
    • 1
    Email author
  • Shawn D. St. Peter
    • 1
  • Charles L. Snyder
    • 1
  1. 1.Department of SurgeryChildren’s Mercy HospitalKansasUSA

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