Acute appendicitis: Weighing up risks and benefits of investigations and treatments

doi:10.1136/bmj.333.7569.652-b

BMJ 2006;333:652-653 (23 September), doi:10.1136/bmj.333.7569.652-b

Letter

Acute appendicitis

Weighing up risks and benefits of investigations and treatments

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

EDITOR—A few issues arise from Humes and Simpson's reviewof acute appendicitis.¹ It is important to clinically assessthe right groin and hip, particularly in paediatric patientsas transient synovitis or irritable hip and septic arthritisare common² and are differential diagnoses that must be consideredfor atypical presentations. Children are often referred withabdominal pain where the gait of the patient has not been assessedand a painful limp can often be missed in a patient examinedonly in the supine position.

Radiological investigations for appendicitis have progressedand computed tomography may be used in the UK in adults, particularlyto rule out right sided colonic pathologies such as cancersand diverticular disease, however for children where radiationexposure is certainly more of an issue, advocating computedtomography scans on the basis of higher diagnostic precisionhas potential risks for the children in question. As so much. . . [Full text of this article]

Sanjay Purkayastha, clinical research fellow

Department of Biosurgery and Surgical Technology, Imperial College, London W2 1NY s.purkayastha@imperial.ac.uk

Sudipta Purkayastha, visiting professor, Paraskeva Paraskevas, senior lecturer

Department of Biosurgery and Surgical Technology, Imperial College, London W2 1NY