How are nausea and vomiting characterized in pediatric appendicitis?

Updated: Oct 25, 2018
  • Author: Adam C Alder, MD; Chief Editor: Carmen Cuffari, MD  more...
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A unique feature of appendicitis is gradual onset of pain followed by vomiting. Vomiting first is more typical of gastroenteritis.

Generally, vomiting that occurs prior to pain is unusual. However, in patients with retrocecal appendices, particularly those that extend cephalad along the posterior surface of the right colon, inflammation of the appendix irritates the nearby duodenum, resulting in nausea and vomiting prior to the onset of RLQ pain.

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