When referring a child with abdominal pain to a surgeon or emergency department for possible appendicitis, I emphasize to the parents that the child must not eat or drink anything until she has been seen at the hospital. Upon evaluation, the child may either be sent home, have a computed tomography scan of the abdomen, be admitted for observation, or be taken directly to the operating room. In all but the first instance, eating or drinking delays or complicates management. 