Acute appendicitis during the first three years of life.

49 children younger than 3 years old and treated for acute appendicitis were investigated retrospectively. The symptoms of this age group are general and diarrhea is not uncommon. Examination of the urine including microscopy should always be performed. The white cell count in peripheral blood is of doubtful value in diagnosing acute appendicitis. A roentgenographic examination of the abdomen was helpful in 78% of the patients studied. The correct diagnosis was delayed in 43% of the cases and this extended the observation time by 2.9 +/- 2.4 days. The appendix was perforated in 79%, complications occurred in 18% and there was no mortality. A high degree of alertness seems essential for the early diagnosis of acute appendicitis in this age group.