4 Have done a similar but smaller study using nuclear scans. Again the technique looks interesting, but is not to be used as the main decision point. Careful examination approaches the same level of accuracy when the false negatives are considered. For the time being, in a regional center such as ours, the diagnosis of appendicitis remains a clinical one. A number of studies have shown this.
Perforation carries a much higher risk of wound infection and other complications.
The morbidity of removing a normal appendix is less than that of missing the diagnosis of appendicitis and allowing rupture to occur. Confusion is highest among women of childbearing age because ovarian and tubal disorders can present in much the same way as appendicitis. In those centers, appendicitis is often seen and treated by junior members of the team. It has been well established that the accuracy of diagnosis is directly tied to the experience of the examiner. In regional centers where all staff members have finished their training and are on the average more experienced, the normal appendix rates are lower.