Specific diseases mimicking appendicitis in childhood.

Of 1,039 children who underwent exploratory surgery with a preoperative diagnosis of acute appendicitis, 112 (11%) did not have suppurative, gangrenous, or perforated appendices. A specific disease other than appendicitis was found in 43 of these 112 children. Three fourths of these children (32/43) had their pathologic process diagnosed at the time of operation: one fourth (11/43) had the diagnosis made postoperatively on the basis of culture, histologic examination, roentgenograms, laboratory studies, or repeated exploratory surgery. More than half (24/43) required operation to treat the disease encountered. Although most of these children had diseases of the adjacent ileum and cecum or the pelvic adnexae, a number had disease outside the immediate operative field. A nonindurated appendix encountered at the time of operation for childhood appendicitis requires a thorough intra-abdominal exploration to exclude another disease that requires operative therapy.