Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Pediatr. Jun 9, 2026; 15(2): 117377
Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.117377
Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.117377
Dilemma between knife and needle for acute abdominal pain in familial Mediterranean fever: Two case reports and literature review
Ahmed M Sira, Department of Pediatrics, Tanta General Hospital, Egyptian Ministry of Health and Population, Tanta 31511, Al Gharbīyah, Egypt
Samar A Shoeir, Mostafa M Sira, Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University, Shebin El-Koom 32511, Menoufia, Egypt
Co-first authors: Ahmed M Sira and Samar A Shoeir.
Author contributions: Sira AM contributed to conceptualization, data curation, investigation, methodology, project administration, supervision, follow-up, and writing of the original draft; Shoeir SA contributed to conceptualization, investigation, methodology, follow-up, and writing of the original draft; Sira MM contributed to conceptualization, investigation, methodology, and writing of the original draft; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the participants’ legal guardians for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Mostafa M Sira, MD, Professor, Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University, Gamal Abdel Nasser Street, Shebin El-Koom 32511, Menoufia, Egypt. msira@liver.menofia.edu.eg
Received: December 8, 2025
Revised: January 7, 2026
Accepted: January 22, 2026
Published online: June 9, 2026
Processing time: 159 Days and 0.1 Hours
Revised: January 7, 2026
Accepted: January 22, 2026
Published online: June 9, 2026
Processing time: 159 Days and 0.1 Hours
Core Tip
Core Tip: Children with familial Mediterranean fever (FMF) can present with acute abdominal attacks that resemble acute appendicitis. Diagnostic discrimination is challenging due to mimicry in clinical, laboratory, and even some radiological findings. We present two children with acute abdominal pain: One was managed surgically despite the lack of radiological evidence of appendicitis. By contrast, the other was managed conservatively despite radiological findings of a slightly inflamed appendix. Both were ultimately diagnosed with FMF. This highlights the importance of differentiating the causes of acute abdominal pain by maintaining a high index of suspicion for FMF, particularly in endemic areas of the Mediterranean basin.