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, acuteappendicitis frequently presents atypically, more frequently misdiagnosed, and thus should be differentlyapproached. Objective: Our aim was discussing the unique features of the appendix and acute appendicitis inchildren, 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 grouphas several peculiarities when compared to adults. It frequently presents atypically, and therefore more commonlymisdiagnosed. An algorithmic approach that integrates a clinical scoring system, such as the PediatricAppendicitis Score and diagnostic studies should be followed. Moreover, when surgery is decided, thelaparoscopic 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.