Johnny is a 10-year-old boy who presents to the emergency department after a 24-hour history of abdominal pain. It started in the periumbilical region and is located in the right lower quadrant. The pain is increasing in severity. His mother knew something was wrong when he did not want to eat dinner or play soccer with friends after school. He was nauseated and developed a low-grade fever. On examination, he is maximally tender over McBurney’s point. An ultrasound confirms acute, uncomplicated appendicitis.
One of the most common pediatric surgical emergencies is appendicitis. The peak incident is in the second decade of life, with a lifetime risk of 7 percent to 8 percent.1
The standard treatment for acute appendicitis, ever since Dr. Charles McBurney described it in 1889, has been appendectomy.2 This surgical approach has been highly successful for more than a century.