The Diagnostic Challenge of Appendicitis in Infancy

The diagnosis of appendicitis in infancy is very difficult to make and is thus usually delayed. This delay is often associated with complications such as perforation and abscess formation as well as prolonged hospital stays and increased litigation. Despite the advent of newer diagnostic tools, such as ultrasonography and CT scan, as well as the volumes of knowledge that have surfaced regarding appendicitis in the younger age group, the diagnostic accuracy has not improved. Experts agree that many clinicians do not have a high enough index of suspicion for appendicitis in the younger child. This case presentation and review of the literature is intended to emphasize to the general practitioner that while appendicitis occurs rarely in infants and toddlers, it should continue to be considered as part of the differential diagnosis in the evaluation of an infant/toddler with vomiting, diarrhea, or a simple “tummy ache”.