The diagnosis of acute appendicitis in children remains a challenge, even for experienced
clinicians. Failure to recognize this acute condition may result in perforation and
subsequent peritonitis, whereas misdiagnosis can lead to unnecessary (negative)
appendectomies. Elevated levels of prostaglandin E urinary metabolites (PGE-M) have been
observed in other inflammatory conditions such as inflammatory bowel disease, acute
mesenteric ischemia, and necrotizing enterocolitis.

The aim of this study is to determine whether PGE-M levels are elevated in children with
acute appendicitis and whether this biomarker could be used in the diagnosis of acute
appendicitis.

The planned duration of the study is 12 months, with a projected sample size of 100
participants.

Inclusion criteria: Children aged 5 to 17 years presenting with acute abdominal pain and
signs and symptoms suggestive of acute appendicitis, without significant comorbidities.

Exclusion criteria: Children outside the specified age range, those with a previously
diagnosed chronic or malignant disease, a history of abdominal surgery, or pregnancy.

For each child included in the study, demographic data, clinical characteristics,
laboratory and diagnostic test results, intraoperative findings, and discharge diagnoses
will be recorded. Since the child is already indicated for surgery or hospital admission
regardless of study participation, there are no significant risks associated with
participation in this study-apart from potential, but rare, complications related to
peripheral venous blood sampling (e.g., hematoma or discomfort).

For the purposes of the study, a peripheral venous blood sample will be collected (on the
day of surgery or hospital admission) to analyze laboratory parameters including
leukocyte count, C-reactive protein, and neutrophils. Additionally, a urine sample will
be collected to determine the levels of prostaglandin E urinary metabolites (PGE-M) and
creatinine