Abstract
Background: Acute appendicitis is the most common abdominal surgical emergency in adults as well as children. Due to the peculiar anatomy of the appendix in children and the unique characteristics of this age group, acute appendicitis frequently presents atypically, more frequently misdiagnosed, and thus should be differently approached. Objective: Our aim was discussing the unique features of the appendix and acute appendicitis in children, and how it's approached and managed. Methods: We searched Pubmed for acute appendicitis, children, anatomy, manifestation, diagnosis, and management. Conclusion: Acute appendicitis in the pediatric age group has several peculiarities when compared to adults. It frequently presents atypically, and therefore more commonly misdiagnosed. An algorithmic approach that integrates a clinical scoring system, such as the Pediatric Appendicitis Score and diagnostic studies should be followed. Moreover, when surgery is decided, the laparoscopic approach is the standard of treatment and should be always used unless contraindicated. In brief, acute appendicitis in children is not just a smaller appendix inflamed.