Incidental finding of acute appendicitis on operating table in pediatric age group patients diagnosed with mesenteric lymphadenitis on abdominal ultrasound

Young children and elderly may have atypical presentation of appendicitis and also have higher mortality and morbidity. They may present with vague abdominal pain of doubtful severity. The problem arises when the appendix base is not visualised due to bowel gas, and the only ultrasound finding is mesenteric lymphadenitis. This prospective study was conducted on patients with vague pain over right iliac fossa and no specific clinical signs of acute appendicitis. On USG abdomen, only mesenteric lymphadenitis was conclusive finding. Patients were taken up for operation on emergency basis and post operatively monitored for 7 days. This study investigates the critical decision-making parameters to determine whether such cases should be taken for appendicectomy with minimal clinical evidence of pain in paraumbilical region.