Appendicitis in children aged 13 years and younger.

During a recent 4 1/2-year period, an increasing number of young children aged 13 years and younger (230 consecutive patients) came to our institution with signs, symptoms, and findings of acute appendicitis, which was perforated in nearly half of the cases (47%). This was accompanied by a marked increase in the number of very young children aged 6 years and younger (32% of our 230 patients). A prompt response to broad preoperative antibiotic coverage and definitive operative intervention (appendectomy in all cases) was found, with no mortality and essentially no major morbidity (less than 1%). The rapid transition from serious illness to near normalcy in the matter of a few hours with a standardized approach to treatment stimulated this review of appendicitis in this pediatric age group in an effort to define factors influencing these findings.