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  • Title: Neonatal acute appendicitis: a proposed algorithm for timely diagnosis.
    Author: Schwartz KL, Gilad E, Sigalet D, Yu W, Wong AL.
    Journal: J Pediatr Surg; 2011 Nov; 46(11):2060-4. PubMed ID: 22075333.
    Abstract:
    BACKGROUND: Neonatal appendicitis (NA) is a rare disease with a high mortality. The diagnosis has never been reported preoperatively and is notoriously difficult to make. METHODS: Charts since 1995 were retrospectively reviewed for discharge or death diagnoses of appendicitis in neonates younger than 28 days. We report 3 cases of NA seen at our institution during this period. RESULTS: All 3 infants were previously well, born at term, and presented with signs consistent with abdominal sepsis. The first 2 diagnoses were not made until autopsy. The third case survived after having an urgent computed tomographic scan, exploratory laparotomy, and appendectomy. DISCUSSION: The literature summarizing common presenting features of NA is reviewed. We present an algorithm to guide the workup of these neonates to facilitate earlier diagnosis and potentially improve outcomes.
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