What is the difference between Brennemann’s syndrome and acute appendicitis?

When Brennemann’s syndrome occurs in children, the symptoms are similar to those of appendicitis, but the condition is usually milder.
If a child has recently developed an upper respiratory infection such as a cold or pharyngitis, and there is no abdominal muscle tension during an episode of abdominal pain, Brennemann’s syndrome is most often considered, and the abdominal pain usually improves significantly after fasting, fluids and antibiotic treatment.
Sometimes it remains difficult to differentiate by various methods and the doctor will explore surgically if necessary to differentiate further.