Today emergency service practitioners are using computerized tomography (CT) for acute abdomen patients more and this may cause reduced rates of NAR. Motoki used CT for AA and published sensitivity and a specificity of 98.9% and 75%, the predictive value of a positive test as 96% and negative test as 90% [11]. Another CT technique uses rectal gastrografin lavmane. Advantages of this technique are, causing no delay for surgery due to oral intake, no need for intravenous contrast and ability to show not only inflamed appendix but also periappendicular inflammatory changes such as mesenteric edema [12, 13].

Hannah et al analyzed the imagination studies as a factor of a delay in surgery and could not show any difference selleck chemical between non-imaging group and imaging group except a reduce of NAR from 10% to 3%

favoring the latter BV-6 concentration [14]. Recent studies are showing short delays due to radiologic examinations have no bad effect on outcome for AA patients but they reduce NAR ratios [15, 16]. There were no statistically significant difference between the length of primary hospital stay for AA and NA group (2.79 +/- 1.9 and 2.66 +/- DNA Damage inhibitor 1.7 days, p > 0.05). Kuzma showed no difference between complication rates for AA and NA groups [17]. Differences in the course for these two groups seem to be that NA patients re-admit emergency services more due to their unsolved problem although appendicitis patients meet more septic complications [18]. Conclusions The diagnosis of appendicitis remains essentially clinical. Our NAR was 11.5 percent for male patients and 27 percent for females. Despite modern techniques, NA rates are still a problem for surgeons. If there is a doubt about the diagnose although leukocyte levels and ultrasonography results are normal, especially for female

patients performing further radiologic examinations such as CT can be favorable. References 1. Liu CD, McFadden DW: Acute abdomen and appendix. In Surgery: scientific principles and practice. 2nd edition. Edited by: Greenfield LJ, et al. Philadelphia: Lippincott-Raven; 1997:1246–1261. 2. Wilcox RT, Traverso LW: Have the evaluation and treatment of acute appendicitis changed with new technology? Surg Clin North Am 1997, Niclosamide 77:1355–1370.CrossRefPubMed 3. Elangovan S: Clinical and laboratory findings in acute appendicitis in the elderly. J Am Board Fam Pract 1996, 9:75–78.PubMed 4. Calder JD, Gajraj H: Recent advances in the diagnosis and treatment of acute appendicitis. Br J Hosp Med 1995, 54:129–133.PubMed 5. Kim K, Lee CC, Song KJ, Kim W, Suh G, Singer AJ: The impact of helical computed tomography on the negative appendectomy rate: a multi-center comparison. Journal of Emergency Medicine 2008, 34:3–6.CrossRefPubMed 6. Hassan AM, Shaban M, Mohsen TK, Ali K, Yashar M: Predicting negative appendectomy by using demographic, clinical, and laboratory parameters: A cross-sectional study. International Journal of Surgery 2008, 6:115–118.CrossRef 7.