The diagnosis of appendicitis in children: outcomes of a strategy based on pediatric surgical evaluation.

Objective: To determine the accuracy of a protocol for diagnosis of appendicitis in children based on clinical evaluation by a pediatric surgeon with selective use of diagnostic imaging studies. We performed this study because 1) current reports in the medical, pediatric, emergency medical, and surgical literature advocate imaging, particularly computed tomography (CT), as the gold standard for diagnosis of appendicitis, and 2) the value of pediatric surgical evaluation early in the management of the child with possible appendicitis has rarely been emphasized. METHODS, DESIGN, SETTING, AND PARTICIPANTS: Retrospective review of 356 children (mean age: 9.

The epidemiology and pathogenesis of necrotizing enterocolitis.

Necrotizing enterocolitis (NEC), a syndrome characterized by crepitant necrosis of the bowel, has emerged as the most common neonatal gastrointestinal emergency in many countries of the world. In the United States, NEC strikes 1 to 8% of patients admitted to neonatal intensive care units, almost all of whom are premature infants. The incidence is low in certain countries wity a low premature birth rate, e.