Decision-Making in Acute Appendicitis: Meta-Analysis versus Clinical Practice

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Abstract
Some statements are made concerning the diagnostic strategy and decision making in acute appendicitis. Ultrasound, although available and applied in many clinical studies, is currently an option for enthusiasts. Diagnostic scoring systems have not fulfilled their theoretical promise. Maybe they are only ‘scientific poetry’. Conservative treatment of acute appendicitis is a viable option for lateral thinkers in surgery. Finally, a more liberal indication for diagnostic laparoscopy more or less including laparoscopic appendectomy should be promoted, provided that the adequate safety standard of this procedure is respected.

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