It's not always appendicitis: relatively uncommon conditions of acute abdomen in children

Aim: To evaluate the acute surgical conditions beyond acute appendicitis in children. Material and method: The children who underwent urgent abdominal surgery between January 2017-December 2020 are retrospectively evaluated. The newborns and patients with acute appendicitis are excluded. Results: A total of 595 patients underwent urgent abdominal surgery. Acute appendicitis was the final diagnosis in 468 of them (78.7%). The median age of the rest of the 127 patients (21.3%) was 8 years (0.96-17.75 years). Fourteen patients admitted with trauma (11%) (12 boys and 2 girls, median age; 12.66 years), and the most common cause was firearm injuries with the most common injured system was the gastrointestinal system. Among the patients without trauma, 62 were boys (54.6%) and 51 were girls (45.1%) (median age; 6.41 years). Intussusception was most common in the Infant and Young Child Group. Adhesive small bowel obstruction was most common in adolescent boys and the Child Group while adnexal torsion was most common in adolescent girls. Intussusception, adhesive small bowel obstruction and gastrointestinal perforation were encountered in all age groups Conclusion: Although acute appendicitis is the most common cause of acute abdomen in children, other causes are not uncommon and some need special attention as differential diagnosis and intervention are "more urgent" than others. Awareness of these "more urgent" conditions with respect to age groups may prevent complications, morbidity, and even mortality