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The Clinical and Economic Correlates of Nonspecific Abdominal Pain Mismanaged by Appendectomy

The Clinical and Economic Correlates of Nonspecific Abdominal Pain Mismanaged by Appendectomy In a recent ARCHIVES article by Flum and Koepsell,1 the authors had rather mixed cards and inappropriately called for the clinical and financial costs incurred by patients undergoing negative appendectomy (NA) to be considered when evaluating system-level interventions to improve the treatment of appendicitis. The implications of NA should be more appropriately considered when the treatment of nonspecific abdominal pain (NSAP) is evaluated. The cause of initial right lower abdominal pain remains unclear in most patients who undergo NA. These patients may be more correctly categorized with a diagnosis of NSAP. The significantly longer hospital stay and greater hospital charges for patients with NA compared with those with appendicitis reflect our failure to identify and to timely and satisfactorily treat or alleviate the causes of NSAP. These issues are not simply a reflection of the surgery. The much greater rate of infectious complications despite the noninflamed appendix may suggest an immune dysfunction associated with obscure causes of NSAP. The authors' title should instead read "The Clinical and Economic Correlates of Nonspecific Abdominal Pain Mismanaged by Appendectomy." References 1. Flum DRKoepsell T The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg. 2002;137799- 804Google ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

The Clinical and Economic Correlates of Nonspecific Abdominal Pain Mismanaged by Appendectomy

Archives of Surgery , Volume 138 (1) – Jan 1, 2003

The Clinical and Economic Correlates of Nonspecific Abdominal Pain Mismanaged by Appendectomy

Abstract

In a recent ARCHIVES article by Flum and Koepsell,1 the authors had rather mixed cards and inappropriately called for the clinical and financial costs incurred by patients undergoing negative appendectomy (NA) to be considered when evaluating system-level interventions to improve the treatment of appendicitis. The implications of NA should be more appropriately considered when the treatment of nonspecific abdominal pain (NSAP) is evaluated. The cause of initial right lower abdominal pain...
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Publisher
American Medical Association
Copyright
Copyright © 2003 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.138.1.111
Publisher site
See Article on Publisher Site

Abstract

In a recent ARCHIVES article by Flum and Koepsell,1 the authors had rather mixed cards and inappropriately called for the clinical and financial costs incurred by patients undergoing negative appendectomy (NA) to be considered when evaluating system-level interventions to improve the treatment of appendicitis. The implications of NA should be more appropriately considered when the treatment of nonspecific abdominal pain (NSAP) is evaluated. The cause of initial right lower abdominal pain remains unclear in most patients who undergo NA. These patients may be more correctly categorized with a diagnosis of NSAP. The significantly longer hospital stay and greater hospital charges for patients with NA compared with those with appendicitis reflect our failure to identify and to timely and satisfactorily treat or alleviate the causes of NSAP. These issues are not simply a reflection of the surgery. The much greater rate of infectious complications despite the noninflamed appendix may suggest an immune dysfunction associated with obscure causes of NSAP. The authors' title should instead read "The Clinical and Economic Correlates of Nonspecific Abdominal Pain Mismanaged by Appendectomy." References 1. Flum DRKoepsell T The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg. 2002;137799- 804Google ScholarCrossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 2003

Keywords: appendectomy,economics,abdominal pain, nonspecific

References