Objective: The prevalence of advanced appendicitis with perforation has been growing higher and higher. In fact, the figure recently has fluctuated around 50 percent of appendicitis cases. Although management of appendicitis was well supported by effective sonography and other subclinical tests, the number of children suffering from appendicitis with perforation has not declined yet. The authors performed the study to determine the rate of appendicitis with perforation among acute appendicitis and to evaluate some risk factors related to late management. Methods and subjects: Retrospective case series of 386 children admitted to the National Hospital of Pediatrics with acute appendicitis with non-perforation and perforation from January to August 2012. Results: The rate of appendicitis with perforation among acute appendicitis is 65 percent. The possibility of suffering from appendicitis with perforation increased in children who were less than 3 years old or had prehistory of treatment before admission or was living outside Hanoi city and suburb. Both specificity (60.2 percent) and sensitivity (51.9 percent) of sonography in diagnosis appendicitis were low. Inadequate clinical pediatric surgical evaluation and description of appendicitis's criteria in sonography were recorded. The accuracy of sonography had a relationship with the number of years of experience of sonographers. Conclusion: The possibility of late management of appendicitis among children under 3 years old was really high. There is a need to establish regulations to ensure that clinical evaluation and sonographic criteria description for appendicitis will be well and adequately performed.
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