Current management of complicated appendicitis in children.

The optimal management for children with complicated appendicitis remains unclear. However, our group has been interested in this disease, and has initiated several prospective randomized trials looking at various aspects of the care of these patients. In this article, we will discuss our definition of perforated appendicitis and how it was derived. We will also discuss a prospective randomized trial looking at the optimal antibiotic regimen and its relative place in the literature as well the data we have generated on the length of antibiotic therapy. We will also review the available data on the timing and necessity of appendectomy for perforated appendicitis. Finally, we will discuss the management of the difficult subset of patients who present with a well-defined abscess.