Which of the following is the LEAST consistent with a clinical diagnosis of acute appendicitis?
A. Normal temperatureB. Normal white blood cell (WBC) count
C. Recent gastroenteritis
D. Vomiting preceding the onset of abdominal pain
Answer. D. Vomiting preceding the onset of abdominal pain
The classic
progression of symptoms of appendicitis occurs more commonly in older children
and adults. Children younger than 2 years often present when the appendix is
already perforated because the preceding symptoms are too nonspecific to call
attention to the pathology. Lack of anorexia or fever and normal WBC counts are
common findings in pediatric patients. Gastroenteritis is often associated with
appendicitis, possibly on the basis of an acutely, but secondarily, inflamed
appendix. Vomiting more commonly presents after
the onset of abdominal pain
