Appendicitis is the most common disease process requiring surgery in childhood. Diagnosis in children can be elusive. As many as 30-45% of patients present with atypical symptoms which mimic such entities as small bowel obstruction, tumor, urinary tract infection, gynecologic processes, and inflammatory bowel disease. A spectrum of illustrative cases were obtained from our review of clinical material from Loyola University Medical Center. The purpose of this computer-generated exhibit is to familiarize the radiologist with typical and atypical clinical and diagnostic imaging findings, complications, and imaging-guided interventional techniques for the treatment of complications. The negative appendectomy rate may be reduced through enhanced understanding of the natural history of appendicitis and its variable presentation in children.

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