Negative appendix with suspected appendicitis: an update.

We report a retrospective study of 282 consecutive patients who had appendectomy for suspected acute appendicitis at the University of Miami/Jackson Memorial Medical Center during a 15-month period. The overall incidence of negative explorations of 7.4% was significantly lower than that reported in the literature, and occurred without a significant increase in the incidence of perforation (22%). Since no sophisticated diagnostic tests were used, we suggest that a decrease in the presently accepted negative exploration rate of 15% to 20% can be achieved on the basis of a careful history, detailed physical examination, and basic laboratory and x-ray studies.