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September 1977

Radiologic Diagnosis of Appendicitis

Arch Surg. 1977;112(9):1148. doi:10.1001/archsurg.1977.01370090130036

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To the Editor.—I read with interest the article by Fee et al (Arch Surg 112:742-744, 1977) and fear it may discourage a useful diagnostic procedure.

Referring to this article, Fig 1 is a beautiful example of a "short" appendix and a "cut-off" sign virtually pathognomonic of appendicitis. I do not agree with the caption, which states it is normal. I agree that Fig 2 does appear normal. Figure 3 is difficult to analyze, but might have a foreshortened appendix or a nonopaque filling defect within it. Some of the difficulty here could be due to the use of a soluble contrast agent. We always recommend barium.

The results on the three patients in the study are interesting, but I question the interpretations. Also, three patients is hardly a "series." How often was a barium enema study utilized with beneficial results?

Actually, we are trying to answer that question with

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