THE SKIN TRIANGLE OF APPENDICITIS: A DISCUSSION OF ITS SIGNIFICANCE AND ITS DIAGNOSTIC VALUE AS OBSERVED IN MORE THAN FOUR HUNDRED CASES OF ACUTE APPENDICITIS

OBJECT OF ARTICLE  The object of this article is to report the value of skin tenderness in the diagnosis of acute appendicitis. The study was conducted in the Third Surgical Division of Bellevue Hospital, service of Dr. George David Stewart, and is based on 428 consecutive cases, over a period of six and one-half years. In a previous article from this division¹ reporting observations on 126 patients, a skin triangle for use in diagnosis was described. At this time proof seemed at hand that skin tenderness limited to the triangle constituted the most important single sign or symptom of acute appendicitis. Such a deduction was too drastic to be reported on the basis of so small a series of cases and it remained for a more extended period of observation to determine the accuracy of this conclusion. The present article constitutes the more extended study.

SIGNIFICANCE OF EARLY WORK