Children & Appendicitis 

• Vomiting may be the first sign. 
• Children may not experience anorexia and may actually request food. 
• Most young children have perforation at the time of diagnosis.
• Children younger than 2 years of age may have generalized symptoms such as irritability and tachypnea. 
• Ultrasonography is useful in evaluation of thin children but is very operator dependent.
• CT with oral contrast and i.v. contrast may be needed to differentiate intraabdominal structures in thin children