Tempering the Technological Diagnosis of Appendicitis

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Abstract
The article by Puylaert et al. in this issue of the Journal 1 concludes that "ultrasonography is a useful aid in the diagnosis of appendicitis" — probably an acceptable summation, provided that it is not interpreted as advocating use of ultrasound studies as a substitute for clinical judgment in the diagnosis of acute appendicitis.As the authors stress, their data indicate that routine imaging techniques combined with clinical diagnosis could reduce the rates of negative celiotomy for suspected appendicitis from the usually reported 17.5 to 20 percent to 8.5 percent. Their results suggest, however, that if ultrasonographic nonvisualization of the appendix . . .