ArticleFrontiers in pediatrics2026
Case Report: Diagnostic challenges in pediatric appendicitis: a case of perforated appendicitis with secondary hepatic abscess.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Appendicitis in young children (age <5 years) frequently presents with atypical symptoms, creating diagnostic challenges in primary care and emergency settings. This report describes a 4-year-old girl who presented to the emergency department with fever, vomiting, and abdominal pain. Initial evaluation including abdominal ultrasound showed no evidence of appendicitis, and she was discharged with a presumptive diagnosis of viral gastroenteritis. Five days later, she was readmitted with persistent symptoms and markedly elevated inflammatory markers. Advanced imaging revealed a hepatic abscess, initially attributed to primary liver pathology. Diagnostic laparoscopy ultimately revealed perforated appendicitis with secondary hepatic abscess. The patient underwent successful laparoscopic appendectomy and abscess drainage with complete recovery. This case highlights the essential clinical approach of maintaining a broad differential diagnosis, recognizing the limitations of imaging, and mandating systematic re-evaluation with structured follow-up when a patient's expected clinical improvement fails to materialize.
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