BMJ 2001;322:615 ( 10 March )

Letters

Ultrasonography in diagnosis of acute appendicitis

    Diagnostic laparoscopy is often more useful than ultrasonography
    Active observation is often sufficient to make diagnosis

Diagnostic laparoscopy is often more useful than ultrasonography

The first 150 words of the full text of this article appear below.

EDITOR---Douglas et al's trial of ultrasonography in the diagnosis of acute appendicitis, and the accompanying editorial, highlight the importance of an accurate diagnosis of acute abdominal pain in the right iliac fossa and the need to avoid unnecessary appendicectomy. 1 2 The results indicate that ultrasonography has little practical value in the diagnosis of acute appendicitis because of false positive and false negative results and the inability to identify alternative diagnoses.

Neither article mentioned the increasing use of diagnostic laparoscopy in these cases. This technique makes an accurate diagnosis clearly; this is especially useful in female patients of any age and in elderly men, in whom diagnostic doubt is common. As well as preventing inappropriate appendicectomy, diagnostic laparoscopy defines the correct operative intervention if an alternative diagnosis necessitates surgery. If surgery is not required a definitive management plan is usually clear. A further advantage of laparoscopy is that if surgeons . . . [Full text of this article]
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Relevant Article

Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score
Charles D Douglas, Neil E Macpherson, Patricia M Davidson, and Jonathon S Gani
BMJ 2000 321: 919. [Abstract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

?Appendicitis” is a separate clinical entity in men and women
Luke Devey, et al.
bmj.com, 13 Mar 2001 [Full text]
Gender data from Douglas et al
Charles Douglas
bmj.com, 7 Apr 2001 [Full text]
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