0
January 1992, Vol 127, No. 1 >
ARTICLE | January 1992

Unnecessary Operation?-Reply

JAY L. GROSFELD, MD
Arch Surg. 1992;127(1):118. doi:10.1001/archsurg.1992.01420010140024.
Text Size: A A A
Published online
Article
Comments

ABSTRACT

In Reply.—Dr Johansen's letter regarding our article concerning HSP is of interest. I believe he is focusing more than necessary on defending the right to perform a laparotomy in which the results are negative for suspected appendicitis. The differential diagnosis of abdominal pain in children is broad, and we agree with Dr Johansen that performing an operation for persistent localized right lower quadrant pain and tenderness is certainly an accepted surgical practice. The bottom line, however, is that children with HSP rarely have localized pain. Their pain is often diffuse and out of context with the clinical findings on physical examination. Furthermore, we could find only one case report of acute appendicitis coexisting with HSP. Appendicitis therefore almost never occurs with this condition.

Whether one wishes to use the term unproductive or unrevealing following a laparotomy in which the results are negative for suspected appendicitis is not the

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs

More Listings at
JAMACareerCenter.com >

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems