In spite of the long term experience gained in more than 100 years of practice, diagnosing acute appendicitis is still a tricky and doubtful charge. This is why surgeons often choose to risk removing a healthy appendix instead of gambling other complications like perforation or gangrene of the organ. The pain in appendicitis is most assembling to aches caused by other major abdominal pathology; cases of negative appendicectomy are found in about 20% of the situations.

Although sometimes negative appendicectomy might seem common and without risks, there are studies confirming high rates of complications and mortality in such mistakes; much higher than in well diagnosed appendicectomy.

The use of scoring system Alvarado has proved to decrease at about 0-5% the risk of negative appendicectomy. A closer and more objective or specialized expertise of the case can highly lower the further explorations until making them unnecessary. Replacing clinical skills of the surgeon by newest domain technology can have, in spite of the expectations, high risks.

In a study comparing patients suspected of acute appendicitis diagnosed by clinical exams and patients investigated through ultrasound technology, scientists have proven no major differences between the two methods. Patients undergoing ultrasound examination got earlier to the operation room as the others but the rate of negative appendicectomy remained high. No major changes were discovered although the operation was restricted to the patients with an Alvarado score of 4-8.

Other clinical studies proved no important differences. Concluding, we can assert that the Para clinical such as ultrasonography is highly dependent on the physician executing it.

The most helpful radiological investigation in avoiding negative appendicectomy seems to be computerized tomography. It reveals differential diagnosis and other possible abdominal pathology and offers more clear images of the explored area. More recent studies have verified the hypothesis that CT-scan reduces the risk of a false appendicitis diagnosis.

Despite of the major benefits of the computerized tomography this type of new technology isn't always available to the clinician in emergency cases when suspecting appendicitis.