How is pediatric appendicitis diagnosed?

Updated: Oct 25, 2018
  • Author: Adam C Alder, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Making a timely diagnosis of appendicitis is a difficult challenge in children with abdominal pain. Laboratory findings may increase suspicion of appendicitis but are not diagnostic. The minimum laboratory workup for a patient with possible appendicitis includes a white blood cell (WBC) count with differential and urinalysis. Liver function tests and amylase and lipase assessments are helpful when the etiology is unclear. Baseline blood urea nitrogen and creatinine are needed prior to intravenous contrast CT scanning.

Other studies, such as interleukin 6 and C-reactive protein (CRP) assays, have been advocated by some in the diagnosis of appendicitis. However, in multiple clinical series, these studies have not been shown to be of clear benefit and, for the most part, only add to the cost of the evaluation.


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