Acute appendicitis in children: is preoperative hyponatremia a predictive factor of perforation/gangrene? A prospective study

This prospective study of 153 children identifies preoperative hyponatremia (sodium <135 mmol/L) as a highly accurate predictor of perforated or gangrenous appendicitis, with 94% sensitivity and 91% specificity. The finding suggests serum sodium assessment should be incorporated into diagnostic algorithms to guide urgent surgical intervention and avoid inappropriate non-operative management.