Chest and abdominal radiograms are most helpful in evaluating acute abdominal pain in children. When basilar pneumonia is found, the likelihood of associated appendicitis is slim. Evidence of appendicolithiasis on abdominal films secures the diagnosis of acute appendicitis and should prompt the surgeon to early operative intervention, since the threat of appendiceal perforation is great. Barium enema is safe and informative when obscure clinical presentation or associated illness exists. The likelihood of appendicitis is great when the appendix fails to fill at the time of barium enema. Complete filling of the appendix excludes the possibility of acute appendicitis.
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