Background: Appendicitis is one of the most common emergency abdominal operations in children. It is estimated that appendicitis is diagnosed in about 2 % of children who present to the emergency department because of acute abdominal pain1. Timely diagnosis and appendectomy can prevent abscess formation, and perforation as well as reduce early and late postoperative complications.

Methods: This study is a retrospective review of all children diagnosed with acute appendicitis in our emergency department between January 2015 – 2018. We have compared the clinical features and the results of examinations between two groups of patients - those who were diagnosed correctly and have been operated, on and those who were misdiagnosed and operated on later respectively more than 24 hours after initial control.

Results: This study includes fifty-nine children less than sixteen years old, admitted to our clinic and operated on due to acute appendicitis. Fifty-three (89.9%) of them were hospitalized after the first control, whereas the remaining six (10.1 %) were discharged home after the initial control. The misdiagnosed patients were returned to our department less than twenty hours after the first control. Compared with the patients in which the diagnosis was made correctly the misdiagnosed patients, in general, had lower levels of leukocytes, CRP, and temperature.

Conclusion: The diagnosis of appendicitis in children can be very difficult because of the atypical features. According to our experience and the data from other studies, still, there is not a single test or combination of clinical and laboratory examinations, able to discriminate between children with and without acute appendicitis with a high percentage of accuracy.

Keywords: Children, appendicitis, misdiagnosed