ABSTRACT
Appendicitis is one of the most common surgical emergencies in children. Prompt appendectomy is the recommended first-line treatment of acute appendicitis, though there have been recent randomized controlled trials in both adults and children showing the possibility of a non-operative approach using only antibiotics. Appendectomy is also the generally accepted treatment of perforated appendicitis. Interval appendectomy is typically performed laparoscopically. Children with appendicitis should be evaluated for degree of sepsis and dehydration. Postoperative nasogastric decompression is indicated only in cases with extensive intra-abdominal contamination or obvious associated small intestinal obstruction due to appendicitis. Surgical complications are more common after complicated appendicitis and include wound infection, intra-abdominal abscess formation, hemorrhage, prolonged paralytic ileus, and intestinal obstruction. Surgical site infection is by far the most common complication but with achievable rates of <5% even for complicated appendicitis.
