Acute appendicitis is one of the most common surgical emergencies in children, and the younger the age, the less typical the symptoms. Acute appendicitis in children mainly has the following symptoms: 1. Abdominal pain is the most common symptom of appendicitis in children, which starts in the umbilicus or upper abdomen and shifts to the right lower abdomen after a few hours; in some cases, the abdominal pain starts in the right lower abdomen and is continuous. Children tend to lie on their right side, with their legs slightly flexed, and walk with their waist to the right. However, children under 5 years of age are often unable to express the symptoms accurately and do not always have abdominal pain as the initial symptom. Vomiting, fever, irritability, diarrhea and refusal to eat are often the early complaints. If the child is found to have paroxysmal crying, refusing to press the abdomen, and unwilling to move, it often suggests abdominal pain; infants may have “bump pain”, that is, the pain is more obvious when tapping or bumping, and crying more than once. Nausea and vomiting are common symptoms of pediatric appendicitis, mostly seen at the beginning of the disease; diarrhea occurs in about 20% of children and constipation in 13%. 3.Most of the children start with moderate fever (measured temperature around 38.5 degrees Celsius), but high fever may appear 1-2 days later, suggesting the possibility of aggravation or appendiceal perforation. The most important sign of acute appendicitis is fixed pressure pain in the right lower abdomen; if the appendix spreads to the peritoneum, there is abdominal muscle tension, accompanied by muscle rebound pain in severe cases. 5.Suddenly during the course of the disease, the child feels less abdominal pain and more abdominal pressure and muscle tension, and the appearance of abdominal distension, which mostly suggests the possibility of appendiceal perforation. Infants and children with atypical symptoms and poor organism defense function are more likely to have appendiceal perforation; if the course of the disease is more than 3 days and the inflammation is still not controlled, appendiceal abscess is likely to be formed, and the appendiceal mass formed by abscess is most in the right lower abdomen, and abdominal puncture is performed via the appendiceal pressure point in the right lower abdomen, and a large number of pus balls can be seen in the puncture fluid, or pathogenic bacteria can be found in the smear. 6, external blood test increased white blood cells, neutrophils accounted for the majority. 7, swollen appendix or appendiceal abscess is detected by abdominal ultrasound. Experts point out that, in general, children are more seriously ill than adults, and perforation can occur within a short time, which can cause serious complications. Parents are reminded that if a child is found to have paroxysmal crying, refusal to press the abdomen and reluctance to move, it often suggests abdominal pain. If repeated examinations reveal fixed and obvious pressure pain in the right lower abdomen, this is a reliable basis for the diagnosis of acute appendicitis. If you see a child with right hip flexion, difficulty in walking with straight back, mental atrophy, and abdominal distension to the point of restricted breathing and refusal to press, you should also consider the possibility of acute appendicitis, which should be taken seriously at this time.