Appendicitis — MRCPCH FOP MCQ

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ModerateGastroenterologyAppendicitisMRCPCH FOP

A 9-year-old boy has central abdominal pain migrating to the right iliac fossa with anorexia and vomiting. He has low-grade fever, guarding and raised neutrophils. What is the most likely diagnosis?

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Correct answer: D — Acute appendicitis

Migrating abdominal pain, anorexia, right iliac fossa tenderness and neutrophilia are typical of appendicitis. Mesenteric adenitis can mimic appendicitis but usually follows a viral illness and lacks progressive localised peritonism. Functional pain should not cause fever, guarding or neutrophilia. The pearl is that migration of pain is more useful than location alone.

Reference: NICE CKS Appendicitis; RCS paediatric surgery guidance