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1
Making a Decision between Acute
Appendicitis and Acute Gastroenteritis
PROFESSOR DR. HIWA OMER AHMED
GENERAL AND BARIATRIC SURGERY
2
Mirror image
 Acute appendicitis is one of the most common
pediatric abdominal emergencies.
 Early diagnosis is vital for a positive outcome.
 However, it may initially present with diarrhea
and vomiting, mimicking acute gastroenteritis,
thus delaying prompt surgery.
3
Predictors
 Five independent predictors of acute
appendicitis included
 Vomiting
 right lower quadrant (RLQ) pain
 stool occult blood (OB)
 white blood cell (WBC) count
 C-reactive protein (CRP).
4
Awareness
 The signs and symptoms of appendicitis are nonspecific and
are common with other diagnoses.
 Do not diagnose gastroenteritis rather than appendicitis
unless the patient has nausea, vomiting, and diarrhea.
 Even with the presence of vomiting and diarrhea, consider
the unusual presentations of retrocecal or pelvic appendicitis.
 Additionally, appendicitis can develop as a sequela of
gastroenteritis associated with lymphoid hyperplasia.
5
Summary
 Classic features of appendicitis include
1. abdominal pain localising over McBurney’s point
2. Fever and loss of appetite
 However, the initial presentation may be atypical or mimic a different
pathological process, leading to delayed diagnosis. Early clinical
suspicion and imaging are useful in diagnosis.

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Making a Decision between Acute Appendicitis and Acute Gastroenteritis

  • 1. 1 Making a Decision between Acute Appendicitis and Acute Gastroenteritis PROFESSOR DR. HIWA OMER AHMED GENERAL AND BARIATRIC SURGERY
  • 2. 2 Mirror image  Acute appendicitis is one of the most common pediatric abdominal emergencies.  Early diagnosis is vital for a positive outcome.  However, it may initially present with diarrhea and vomiting, mimicking acute gastroenteritis, thus delaying prompt surgery.
  • 3. 3 Predictors  Five independent predictors of acute appendicitis included  Vomiting  right lower quadrant (RLQ) pain  stool occult blood (OB)  white blood cell (WBC) count  C-reactive protein (CRP).
  • 4. 4 Awareness  The signs and symptoms of appendicitis are nonspecific and are common with other diagnoses.  Do not diagnose gastroenteritis rather than appendicitis unless the patient has nausea, vomiting, and diarrhea.  Even with the presence of vomiting and diarrhea, consider the unusual presentations of retrocecal or pelvic appendicitis.  Additionally, appendicitis can develop as a sequela of gastroenteritis associated with lymphoid hyperplasia.
  • 5. 5 Summary  Classic features of appendicitis include 1. abdominal pain localising over McBurney’s point 2. Fever and loss of appetite  However, the initial presentation may be atypical or mimic a different pathological process, leading to delayed diagnosis. Early clinical suspicion and imaging are useful in diagnosis.