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In a retrospective 3-year chart review of 816 children who underwent appendectomy for histopathologically confirmed appendicitis, investigators determined that 39 (5%) had been misdiagnosed on their first emergency department visit and were properly diagnosed at re-presentation within 3 days. Multivariate analysis found no association with age, race, or ethnicity, or Medicaid status. Of the misdiagnosed, 13% had documented right lower quadrant pain, 36% had fever, and 25% had diarrhea. The most common incorrect diagnoses were acute gastroenteritis (44%), constipation (10%), emesis (10%), and abdominal pain not otherwise specified (18%).
On first encounter, median duration of symptoms was similar between those with missed and non-missed appen…