Sosner Eitan, Patlas Michael N, Chernyak Victoria, Dachman Abraham H, Katz Douglas S
Stony Brook University School of Medicine, Stony Brook, NY.
Hamilton General Hospital, McMaster University, Hamilton, ON, Canada.
Curr Probl Diagn Radiol. 2017 Sep-Oct;46(5):360-364. doi: 10.1067/j.cpradiol.2017.03.003. Epub 2017 Mar 18.
The failure to diagnose acute appendicitis (AA) is the third most common medical malpractice allegation related to gastrointestinal disease. There is a paucity of detailed data on this topic; however, publications by Whang et al and by Berlin and Berlin, which analyzed all types of malpractice suits against radiologists, have shown that the incidence of litigation has increased over time in the United States. This is likely true for cases of AA as well. The misinterpretation of cross-sectional imaging in patients with suspected appendicitis may be caused by suboptimal technique, errors of omission, i.e, missing key findings, failure to review a portion of the examination, and satisfaction of search error. This article summarizes the published legal, clinical, and imaging literature regarding litigation in cases of missed AA, and reviews optimized multidetector computed tomography and magnetic resonance imaging protocols for the diagnosis of AA, with examples shown of challenging cases.
未能诊断出急性阑尾炎（AA）是与胃肠道疾病相关的第三大常见医疗过失指控。关于这一主题的详细数据匮乏；然而，Whang等人以及Berlin和Berlin发表的分析针对放射科医生的各类医疗过失诉讼的文章表明，在美国，诉讼发生率随时间有所上升。AA病例可能也是如此。对疑似阑尾炎患者的横断面成像解读错误可能是由于技术欠佳、漏诊错误（即遗漏关键发现）、未对检查的一部分进行复查以及检查满足感误差所致。本文总结了已发表的关于漏诊AA病例诉讼的法律、临床和影像学文献，并回顾了用于诊断AA的优化多排螺旋计算机断层扫描和磁共振成像方案，同时展示了具有挑战性的病例示例。
