PEDIATRIC APPENDICITIS: CURRENT DIAGNOSTIC STRATEGIES, MINIMALLY INVASIVE SURGERY, COMPLICATIONS, AND OPTIMIZED TREATMENT

Acute appendicitis is one of the most common surgical emergencies in children and represents a major cause of acute abdominal pain requiring hospital evaluation. The disease results from inflammation of the vermiform appendix and may progress rapidly to perforation, abscess formation, peritonitis, and sepsis. Diagnosis in children can be challenging because clinical manifestations vary according to age and disease stage. Younger children may present with nonspecific symptoms, while older children more frequently demonstrate the classic pattern of abdominal pain, anorexia, nausea, vomiting, and fever. Modern diagnosis combines clinical assessment, laboratory investigations, validated clinical scoring systems, and imaging techniques, particularly ultrasonography. Computed tomography and magnetic resonance imaging may be reserved for selected cases when the diagnosis remains uncertain. Treatment has traditionally relied on appendectomy, but laparoscopic appendectomy has become the preferred surgical approach in many pediatric centers because of its minimally invasive nature and favorable recovery profile. Selected uncomplicated cases may also be managed initially with antibiotics, although patient selection and the risk of recurrence remain important considerations. Complicated appendicitis requires individualized management, including antibiotics, drainage when appropriate, and surgery in selected patients. Early recognition, appropriate imaging, timely antimicrobial therapy, and minimally invasive surgery can reduce complications and hospital stay. This article reviews contemporary diagnostic strategies, surgical management, complications, and optimized treatment approaches for pediatric appendicitis.