List clinical features.
The reliability of signs and symptoms in children is lower.
Most reliable symptoms: emesis and duration of pain, abdominal tenderness and pain with walking, jumping, and coughing
List diagnostics.
Routinely obtain laboratory studies; initial CRP ≥ 10 mg/mL and WBC count > 16,000/mL strongly predict appendicitis.
Consider either of the following clinical risk scores:
Alvarado score
Pediatric appendicitis score: A scoring system to estimate the likelihood of appendicitis in patients 3–18 years of age [59][60]
Ultrasound is the diagnostic procedure of choice.
Pediatric appendicitis score.
The diagnosis should not be based solely on the clinical score in children.
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