Ovesen H, Christensen B A, Holm N R
Parenkymkirurgisk afdeling, Naestved Centralsygehus.
Ugeskr Laeger. 1991 Jan 14;153(3):190-2.
In order to estimate the specificity of the clinical diagnosis of acute appendicitis, case records of 148 patients, who underwent appendectomy or who were diagnosed as having periappendicular abscess during one year at a regional hospital in Denmark were analyzed. Operations without finding acute appendicitis occurred in 25.4 per cent of the patients. The group of women in the fertile age (12-50 years) was prone to unnecessary surgery (51.9 per cent in this group had a normal appendix). In children, men and non-fertile women only a few patients had unnecessary surgery. Belated diagnoses (perforation and/or abscess) were found truly in 10.7 per cent of the cases, and, with a significant higher incidence, in elderly patients (age greater than 50 years). The possibilities of diminishing the incidence of unnecessary surgery and belated diagnoses are discussed.
为了评估急性阑尾炎临床诊断的特异性，对丹麦一家地区医院一年内接受阑尾切除术或被诊断为阑尾周围脓肿的148例患者的病历进行了分析。25.4%的患者手术中未发现急性阑尾炎。育龄期女性（12 - 50岁）组更容易接受不必要的手术（该组51.9%的患者阑尾正常）。在儿童、男性和非育龄期女性中，只有少数患者接受了不必要的手术。在10.7%的病例中确实发现了延迟诊断（穿孔和/或脓肿），且在老年患者（年龄大于50岁）中发病率显著更高。文中讨论了降低不必要手术和延迟诊断发生率的可能性。
