It’s the beginning of a new academic year – and whether or not you are entering the ED for the first time, or returning after a hiatus it’s a good time to catch up on the basics. That’s what these “Starter Packs” are about. I have collated a number of different posts to give you an idea of what I’ve shared over the past few years on a number of common conditions. This one focuses on appendicitis.


Test Yourself: The Pediatric Appendicitis Score

Why we do what we do: Ultrasound for appendicitis

Quick hits: Here’s why the appendix is more likely to be perforated upon presentation in younger kids

How useful is the pediatric appendicitis score in adolescent females?

And, from the Annals of Emergency Medicine article entitled ”

What Elements of the History, Examination, Laboratory Testing, or Point-of-Care Ultrasonography Are Most Useful in the Diagnosis of Acute Appendicitis in Children?” by Favot et al. here is a table of the test characteristics of various signs, symptoms and markers in acute appendicitis. The authors note the following, which I think is a key take home point:

None of the identified history, physical examination, or labora- tory findings had sufficient posi- tive or negative likelihood ratios to rule in or rule out acute appendi- citis in patients with suspected acute appendicitis.

Mark J. Favot, MD & Robert R. Ehrman, MD, Annals of Emergency Medicine