Various factors play a role in childhood acute abdomen etiology. In our study we evaluated the role of appendicoliths in childhood abdominal pains and appendicitis. Official records of 319 patients who referred with abdominal pain between the years 2002 to 2006 years were evaluated. ( Among the 155 patients being operated )101 appendicitis, 27 perforated appendicitis, 7 meckel diverticulitis were found. 20 false laparatomies were distributed as; 9 with no obvious pathology, 7 with mesenteric adenitis, 4 with appendicoliths obstructing the lumen but no macroscopic change in appendix. The results of 164 patients hospitalized due to abdominal pain and observed according to suspicious examination findings were; 85 mesenteric adenitis, 19 gastroenteritis, 8 tonsillitis or otitis, 3 familial mediterranean fever, 1 hydrosalphinx and 21 with no obvious etiology. In 27 cases fecal particles (appendicoliths) obstructing appendix lumen and leading to inerease in outer diameter of appendix wall were detected by sonographically. Those patients were observed medically according to their mild and suspicious clinic of abdominal pain. These Patients were discharged with close follow up according to improving clinic complaints and sonographic findings. In our serial, we detected that appendicoliths can mimic acute abdominal pain without any real underlying surgical pathology. As a consequence; despite appendicoliths mostly disturbs physicians for a surgical intervention, sonographical appendicoliths diagnosis is not a sufficient criteria for differential diagnosis. So we suggest close follow up in such patients

Keywords: Children, acute abdomen, appendicoliths, appendicitis