سؤال من احد الزملاء تشخيص acute appendicitis In children presented with acute abdomen pain vomiting and fever الاجابه فى ثلاث نقاط رقم 1️⃣ تشخيص الزايده عامل زى puzzle مفيش حاجه لوحدها تشخص لازم Proper history and physical examination With interpretation with lab and radiology ( US abd and CT if available) رقم 2️⃣ الزايده من الحاجات اللى أعراضها بتتغير كل شويه وممكن مش تكون واضحه فى بدايه الاعراض وبتظهر اكتر مع الوقت علشان كده لازم تفحص الطفل وتتابعه كل شويه Do frequent examination and evaluation: رقم 3️⃣ لو لسه الدنيا مش واضحه خد راى الجراحه Consult pest surgery if you are in doubt?! آخر نصحيه🚨🚨 الاعراض دى غالبا بتتشخص بالغلط انها نزله معويه ( ابداً ابداً أبداً مش تشخص نزله معويه من غير إسهال) ✅ Ezz Clinical Cards Pediatric Gastroenterology Clues Appendicitis Diagnosis in Children – Clues Not to Miss! 🚨🚨 Clinical Clues: • Pain starts peri-umbilical → migrates to RLQ • Child prefers lying still (movement worsens pain) • Guarding & rebound tenderness in RLQ • Pain precedes vomiting (not the other way around) • Anorexia is almost always present • Fever is usually mild, not high early on 🧪 Lab Clues: • Elevated WBC count with left shift (↑ neutrophils) • CRP may support, but not confirm diagnosis 📸 Imaging Clues: • Ultrasound first (non-invasive): • Non-compressible, blind-ending tubular structure >6mm • Free fluid, echogenic fat = supportive signs • If unclear → CT with contrast (higher sensitivity) 🎁 Bonus Clinical Pearl: 💪 Never rely on one clue alone. Combine history + physical + labs + imaging. If in doubt, repeat the exam! Appendicitis evolves over time. ⸻ #ezzclinicalcards #pediatricgastroenterology #acuteabdomen #pediatricsurgery #appendicitisinchildren #giclues #don’tMissThis #childabdominalpain #إذكروا_الله ❤ #صلى_على_الحبيب_قلبك_يطيب ❤