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The impact of diagnostic delay on the course of acute appendicitis
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  • Published on:
    Impact of diagnostic delay on acute appendicitis

    Dear Editor

    Cappendijk and Hazebroek (Arch Dis Child 2000;83:64-6) conclude from their data that "the major factor in delay is suspected gastroenteritis". Other studies have not given this factor such prominence and the study population suggests that the Sophia Hospital was acting as a referral centre: 32 of 78 children whose admission was delayed for 48 hours had been seen first by a paediatrician, which may i...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re: The impact of diagnostic delay on the course of acute appendicitis

    Dear Editor

    The article from the Netherlands by Cappendijk and Hazebroek[1] has again confirmed what is already known in clinical practice. A recent paper from the Leicester Royal infirmary[2] is almost identical.

    As the authors pointed out, the factors determining the diagnostic delay are numerous and often cannot be influenced. However, I agree with their statement that “in a child with abdominal pai...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re: Factors delaying diagnosis of appendicitis in children

    Dear Editor

    In reply to the comments by Yim Yee Chan and R Lakshman in which they ask if all patients truely suffered from appendicitis in our study group. The answer is that histopathological investigation confirmed the diagnosis appendicitis in all cases.

    Yours sincerely,

    VC Cappendijk, MD and FWJ Hazebroek, MD, PhD
    Department of Paediatric Surgery, Sophia Children's Hospital...

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    Conflict of Interest:
    None declared.
  • Published on:
    Factors delaying diagnosis of appendicitis in children
    • Yim Yee Chan, Research Fellows
    • Other Contributors:
      • R Lakshman

    Dear Editor

    The paper by Cappendijk and Hazebroek[1] successfully demonstrates the problems with diagnosis of appendicitis in the young child.

    It makes the important point that diarrhoea may be a feature of appendicitis and lead to misdiagnosis. In addition, children can have coexisting pathologies leading to delayed diagnosis. We have seen a cystic fibrosis child with DIOS (distal intestinal obstruction...

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    Conflict of Interest:
    None declared.