[Acute appendicitis in children under 4 years:a diagnostic dilemma].

Introducction: Acute appendicitis is a pathology caused by inflammation of the cecal appendix , due tocthe obstruction of the appendicular lumen,witch leads to a venous congestion and then eventually to an arterial compromise of the appendicular wall with the consequent perforation of it.The main problem of this pathology in children under 4 years is the high index of appendicecal preforations presented by patients at the time of diagnosis,mainly driven by an unspecific clinical presentation,which leads to a low index of suspicion and a high percentage of complications in that age group.

Objetive: perform a literature review on the subject and investigate what is known of appendicitis in children under four years old to date. The data were obtained through a systematic bibliographic search in the pubmed data base from 1980 to 2017

Conclussion: Conclussion the increase in morbidity of acute apendicitis in children under 4 years has a mixed origin since organic factors are mixed age,together with a temporary diagnostic delay and with it the appearance of complicated forms of the disease, there is no sign,symptom or group of them that allows early detection of appendicitis in children under 4 years of age.