Appendicitis is a separate clinical entity in men and women

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 …