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2004; Ingraham et al. 2010; Hunter 2010). In Our Lady’s Hospital for Sick Children in Dublin, Ireland a policy of delaying surgery to morning was instituted in the late 1980s. Surana compared the outcome of patients presenting during the day and operated on or before midnight, with a group of patients who presented or were diagnosed during the night hours and were placed on antibiotics and operated on the next morning. There were 695 patients in total. No significant difference in rates of perforation (18 vs.

Complications due to the unnecessary operation as wound infections, abscesses, ileus, hemorrhage and urine retention occurred in 6% of the patients and in 2% of the patients a re-operation was needed. This high complication rate is confirmed by others (Gough et al. 1983). 3% and the re-operation rate was 0%. No Table 1 Hospital costs in 2003 of different procedures or interventions Visit emergency ward: € 29 Consultation surgeon or resident: € 14 Routine laboratory examination: € 14 Ultrasound: € 63 CT-scan: € 88 Operation room costs diagnostic laparoscopy: € 267 Surgeon fee diagnostic laparoscopy: € 47 Anaesthesiologist fee diagnostic laparoscopy: € 30 One day admission: € 469 Operation room costs appendectomy: € 363 Surgeon fee appendectomy: € 163 Anaesthesiologist fee appendectomy: € 54 Extra costs laparoscopic appendectomy: Three Endoloop Ó EJ 10C: € 93 EndocatchÓ: € 108 Outpatient clinic control: € 44 Histopathologic examination: € 24 Costs in 2003 in Euro’s, source (Bijnen et al.

Am Surg 72:326–329 Musunuru S, Chen H, Rikkers LF, Weber SM (2007) Computed tomography in the diagnosis of acute appendicitis: definitive or detrimental? J Gastrointest Surg 11:1417–1421 Naoum JJ, Mileski WJ, Daller JA et al (2002) The use of abdominal computed tomography scan decreases the frequency of misdiagnosis in cases of suspected appendicitis. Am J Surg 184:587–589 Omundsen M, Dennett E (2006) Delay to appendicectomy and associated morbidity: a retrospective review. ANZ J Surg 76:153–155 Peña BM, Taylor GA, Fishman SJ, Mandl KD (2002) Effect of an imaging protocol on clinical outcomes among pediatric patients with appendicitis.

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BMX Bandits Scholastic


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