A Case Report Highlighting Some of the Difficulties Faced Diagnosing Appendicitis in Children

A Case Report Highlighting Some of the Difficulties Faced Diagnosing Appendicitis in Children

S. Lewis, A. Rasheed

Royal Gwent Hospital

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Introduction: In England 12,000 children are diagnosed with appendicitis each year. The diagnosis of appendicitis is difficult especially in children. There are many other diagnoses which mimic appendicitis including Meckel’s diverticulum, intussusception, gastroenteritis and mesenteric adenitis. Unfortunately there is no gold standard in the diagnosis of appendicitis and often clinicians are hesitant to submit a child to radiological investigations.
Presentation of the case: An eleven year old boy, of Bangladeshi origin, presented to the Royal Gwent Hospital, South Wales, with an acute onset of centralised abdominal pain and vomiting. Following a period of observation and re-examination his pain had localised to the right iliac fossa and it was decided on clinical grounds to perform a laparoscopy for suspected appendicitis. Intra-operative findings showed an intussusception of the small bowel secondary to a mucosal lesion. Histology showed high grade non-Hodgkin’s lymphoma with a pattern suggestive of Burkitt’s lymphoma.
Conclusion: The case highlights the importance of accurate diagnosis of appendicitis and the difficulties of managing abdominal pain in children. More needs to be done to develop a better criterion and judicial use of imaging to guide surgical intervention.

Keywords: Appendicitis, Alvarado, Ultrasound, Computer Topography, Laparoscopy

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How to cite this article:
S. Lewis and A. Rasheed.A Case Report Highlighting Some of the Difficulties Faced Diagnosing Appendicitis in Children. International Journal of Case Reports, 2018 3:38. DOI:10.28933/ijcr-2018-10-1208


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