ACUTE APPENDICITIS IN A 12-YEAR-OLD PEDIATRIC PATIENT: A CASE REPORT

Abstract

DOI: https://doi.org/10.46296/gt.v9i17.0381

Abstract

Introduction: Acute appendicitis (AA) is one of the most common causes of acute abdomen in pediatrics. Its diagnosis remains challenging due to overlapping symptoms with other conditions. Objective: To present the case of a 12-year-old patient with AA, review the current evidence on the diagnostic-therapeutic approach, and discuss key management decisions in pediatrics. Clinical case: A previously healthy 12-year-old male with 24 hours of abdominal pain migrating to the right iliac fossa, nausea, low-grade fever, and anorexia. The examination revealed pain on deep palpation and rebound tenderness. Laboratory tests showed leukocytosis (14,800/mm³, 84% neutrophils) and elevated CRP. Scores: Alvarado 8/10 and Pediatric Appendicitis Score (PAS) 7/10. Ultrasound: non-compressible appendix measuring 7.5 mm in diameter with hyperemia and hyperechoic periappendicular fat; no collection or appendicolith. Early laparoscopic appendectomy was performed with favorable postoperative evolution and discharge at 24 hours. Discussion: In pediatrics, clinical scoring systems help stratify risk and select imaging, with ultrasound as the first-line modality due to the absence of radiation; laparoscopy is the surgical standard due to lower morbidity. Antibiotic therapy alone may be considered in selected cases of uncomplicated appendicitis, but there is a risk of recurrence. Conclusion: The combination of structured clinical evaluation, targeted imaging, and minimally invasive surgery allows for safe and effective management of AA in children.

Keywords: Acute appendicitis; Pediatrics; Laparoscopic appendectomy; Ultrasound; Alvarado score.