Acute Appendicitis in Infants and Toddlers: Rare but Challenging

The diagnosis of appendicitis in infancy is very difficult to make and is thus usually delayed causing complications such as perforation and abscess formation as well as prolonged hospital stays. Though appendicitis in infants and toddlers is a rare happening, it should nevertheless be overseen in children presenting with colicky pain, vomiting (and/or diarrhea), and fever. Delayed diagnosis is common, particularly in young children, with perforation correlating strongly with delayed diagnosis. WBC and CRP have been demonstrated to be well correlated to the diagnosis of appendicitis in infants and toddlers. Rate of appendiceal perforation is extremely high in infants. Hospitals should develop clinical and imaging protocols that they can use effectively. In countries with limited resources, these protocols should be adapted to the cost effectiveness of the diagnosis and duration of hospital stay. Reducing the morbidity depends largely on increasing the rate of surgical diagnosis at the first presentation to a medical clinic.