Appendicitis is commonly seen in children between the ages of 6-12 and is known as the most frequently missed surgical pathology. The appendix, found in the lower right abdomen of most people, is an intraperitoneal organ. In children, the appendix is narrower, longer, and has thinner walls compared to adults, leading to easier perforation.

Inflammation occurs and appendicitis develops when the appendix lumen is blocked due to reasons such as lymphoid hyperplasia, fecalith, foreign bodies, or parasites. The stretching of the appendix is transmitted to thoracic ganglia by receptors and then to umbilical dermatomes. Therefore, the pain first starts around the navel and then settles in the lower right abdomen. In the case of perforated appendicitis, widespread abdominal tenderness, defensive and rebound signs are observed.

In acute appendicitis cases, pain around the navel and loss of appetite are generally observed. Vomiting usually starts later and is accompanied by leukocytosis with a fever of 38-39°C. During the physical examination, tenderness, defensive and rebound signs are observed in the lower right abdomen (McBurney's point). In a rectal examination, there may be tenderness, an increase in temperature, and a feeling of fullness in the ampulla. Complete blood count, complete urine analysis, arterial blood gas analysis, and abdominal ultrasonography are helpful in diagnosis. A plastron and periappendicular abscess can be identified with ultrasonography.

Patients receive prophylactic antibiotic and fluid therapy and a nasogastric tube (NGT) is inserted. Then, patients are taken to surgery. In acute appendicitis cases, usually only appendectomy is performed, while in perforated cases, a drain is also placed for drainage purposes along with appendectomy. In acute cases, the NGT is removed 24 hours after surgery and oral feeding is started. In perforated cases, the NGT is removed within 24-48 hours and oral feeding is started afterward.

In acute appendicitis, pre- and postoperative antibiotic therapy is usually sufficient, while in perforated cases, an antibiotic protocol targeting Gram (-), Gram (+), and anaerobic microorganisms is applied for 7-10 days.

Today, the mortality rate of appendicitis is between 0.1-1%. Postoperative complications may include wound site infection, intraabdominal abscess, and brid ileus.