What is a red flag symptom of acute appendicitis in a child?

• A. Peri-umbilical pain migrating to the right lower quadrant, fever, anorexia
• B. Severe sore throat with fever
• C. Diarrhea
• D. Headache

Answer: (A)

Migratory abdominal pain is a key signal for acute appendicitis in children. Pain that starts around the belly button (periumbilical) and then moves to the right lower quadrant, often with fever and a reduced appetite, reflects the typical progression as inflammation irritates the visceral nerves first and then the parietal peritoneum in the RLQ. This combination of migrating pain plus fever and anorexia strongly suggests appendicitis and warrants urgent assessment to prevent complications like perforation.

Other options don’t fit this pattern: a severe sore throat with fever points more toward a throat infection; diarrhea suggests gastroenteritis or another GI issue; headache is nonspecific and not characteristic of acute appendicitis in a child.