title: An analysis of factors influencing accuracy of the diagnosis of acute appendicitis.
abstract: The aim of the study was to "refresh" the knowledge about the course of acute appendicitis, to confront the classical clinical picture with the practice, analyze its fluctuations and identify factors influencing these.
  
  
  METHODS
  All patients admitted to the Department of General Surgery in Grudziądz District Hospital with the suspicion of acute appendicitis, who underwent appendectomy and in whom the appendicitis was confirmed in pathologic examination were included in the study. There were 85 patients, 49 men (58%) and 36 women (42%) in a mean age of 30 years (range 10-75). Symptoms, signs and results of biochemical tests (leukocyte rate and CRP) were considered in the analysis.
  
  
  RESULTS
  The commonest constellation of symptoms and signs, occurring in at least of 3/4 patients consisted of pain and tenderness localized in right lower quadrant (100%), which exacerbates at movements (98%), felling unwell (93%), loss of appetite (88%), and rebound tenderness in right lower quadrant (74%).
  
  
  CONCLUSIONS
  No particular fluctuation of clinical features in relation to gender, age, duration of symptoms, biochemical parameters and morphological severity of the inflammation was observed. Relevant findings included relatively fast development (<12 hrs) of advanced appendicitis in 18% of adult patients and more than a half patients with normal body temperature, regardless true appendicitis.
authors.affiliation: Department of General and Hand Surgery, Pomeranian Medical University in Szczecin.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Zyluk
authors.forename: Paweł
authors.initials: P
authors.lastname: Ostrowski
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000453:epidemiology; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods; D001064:Appendicitis / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D015984:Causality; D002648:Child; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data*; D010808:Physical Examination / Q000706:statistics & numerical data*; D011044:Poland / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult