How do we determine if your child has appendicitis?

Pediatric Emergency Medicine physicians are experts in determining if your child has appendicitis. We begin with a thorough history and physical exam. Next, we consider this information to stratify your child's risk for appendicitis based on the most current research. For example, we use information that we obtain from the history and physical exam to help us determine if your child is at low, medium, or high risk for having appendicitis. We may order blood or urine tests to help us make the diagnosis. Imaging tests like ultrasound scans and CT scans ("cat scans") may be used to get pictures of the inside of your child's body.

Low risk:
  • Low risk children are those that are unlikely to have appendicitis. These are children:
    • who have no nausea or vomiting and are eating well, and
    • whose worst belly pain is somewhere other than the right lower belly, and
    • whose blood tests do not suggest infection
  • If we determine that your child is at low risk, we will ask you to keep a close eye on your child and have them re-checked within 12-24 hours.
Medium risk:
  • Medium risk patients have some symptoms and signs of appendicitis but not enough to have surgery right away.
  • If your child is at medium risk, an ultrasound scan may be the next step. We prefer ultrasound as it limits the amount of radiation that a child is exposed to. However, if the ultrasound does not give us an answer, a CT scan may be performed.
High risk:
  • High risk patients have many symptoms of appendicitis and have concerning lab tests and physical exam findings.
  • If your child is at high risk, the surgery team may be called to see your child. An ultrasound or CT scan may also be done. Your child will likely stay in the hospital so that we can watch him/her very closely or so they can have surgery to remove the appendix.