BMJ 2001;323:50 ( 7 July )

Letters

Diagnosis of acute appendicitis

    Appendicitis is a separate clinical entity in men and women
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Appendicitis is a separate clinical entity in men and women

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

EDITOR---We read with interest the randomised controlled trial of ultrasonography in the diagnosis of acute appendicitis reported by Douglas et al.1 This trial would add more to the literature if it were to acknowledge sex differences in the management of abdominal pain.

On every surgical take, the investigation of pain in the right iliac fossa differs between men and women. Often women have an ultrasound examination of the pelvis and abdomen primarily to exclude gynaecological or pelvic pathology. Conversely, men are much more commonly assessed by repeated clinical examination. Given the marked difference in the differential diagnosis of pain in the right iliac fossa in men and women, we argue that it should be seen as two separate clinical problems. To illustrate the above difference, we performed a retrospective analysis of 59 consecutive cases of pain in the right iliac fossa from the first three months of 2000 at the . . . [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]

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