Lest we forget the clinical and economic costs of misdiagnosed appendicitis, Drs Flum and Koepsell surveyed widely and found that patients who underwent negative appendectomies had longer hospital stays, greater hospital charges, greater case fatality, and a higher rate of infectious complications. At least 85% of patients with symptoms and signs of appendicitis can be diagnosed by medical history and physical examination. Misdiagnosis is more common among the very young and very old, women, and those with higher levels of comorbidity. Despite the expense and time constraints, isn't computed tomographic scanning of the abdomen an appropriate test? Although this is advocated, the test should be supervised by the attending surgical consultant so that its use can be limited to "in doubt" situations.