[Acute appendicitis: avoiding unnecessary laparotomy in young women]

Eighty-eight consecutive patients undergoing surgery for clinical diagnosis of appendicitis are reviewed. The diagnosis was correct in 71 (85%), incorrect in 17 (15%). Of these 17 patients 5 suffered from other diseases demanding surgical treatment (diverticulitis, cholecystitis, torsion of ovarian cyst, pyosalpinx). Pain migration, local tenderness and WBC greater than 10,000/mm3 were significantly associated with appendicitis, whereas duration of pain, défense musculaire and body temperature did not allow any discrimination. In men, the diagnosis was correct in 42 out of 43, whereas in women only in 34 out of 45. All 11 women with incorrect diagnosis were less than 35 years old. We conclude that the diagnosis of appendicitis is particularly difficult in women younger than 35 years.