Natesha R, Barnwell S, Weaver W L, Hoover E L
J Natl Med Assoc. 1989 Mar;81(3):269-71.
A retrospective review was conducted to determine if there were identifiable racial markers in patients who were explored and misdiagnosed as having appendicitis. Between May 1983 and May 1987, 100 patients were explored for appendicitis. There were 65 whites and 35 blacks with a male predominance in each group. The age range was 4 to 70 years with a mean of 47 years; 30% of each group was in the pediatric age range (less than 17 years old). Eight patients had a normal appendix including two blacks: a 20-year-old male with no pathologic diagnosis and a 42-year-old female with a ruptured cornual pregnancy. Although the sample size was small, there was a trend toward a lower white blood cell count in blacks when appendicitis was confirmed at surgery (11,000 cells/microL +/- 3,000 v 17,000 cells/microL +/- 3,000). The following conclusions can be drawn: (1) the accuracy of diagnosis should be considerably lower than the 20% commonly quoted; (2) the likelihood of an incorrect diagnosis appears to be higher in adults in both groups without a sexual predilection; and (3) there may be a trend toward a higher initial white blood count in whites compared with blacks with acute appendicitis.
进行了一项回顾性研究，以确定在那些接受探查但被误诊为阑尾炎的患者中是否存在可识别的种族特征。在1983年5月至1987年5月期间，100例患者因阑尾炎接受了探查。其中有65名白人患者和35名黑人患者，每组均以男性居多。年龄范围为4至70岁，平均年龄为47岁；每组中30%为儿童年龄范围（小于17岁）。8例患者阑尾正常，其中包括2名黑人：一名20岁男性，无病理诊断；一名42岁女性，患有输卵管间质部妊娠破裂。尽管样本量较小，但在手术中确诊为阑尾炎时，黑人的白细胞计数有低于白人的趋势（11,000个细胞/微升±3,000对17,000个细胞/微升±3,000）。可以得出以下结论：（1）诊断的准确性应远低于通常引用的20%；（2）两组中无性别倾向的成年人出现误诊的可能性似乎更高；（3）与患有急性阑尾炎的黑人相比，白人可能有初始白细胞计数较高的趋势。
