Diagnosis of acute appendicitis: increasing accuracy, improving outcome, and decreasing liability.

When patients present with classic features, the diagnosis of appendicitis is generally straightforward. However, a large number of patients present with atypical features. Physicians must understand the limitations of the clinical examination and many other diagnostic adjuncts currently available. They also need to be aware of high-risk populations. Importantly, physicians must not be reluctant to consult surgical specialists in borderline cases. Only by consulting in such cases will physicians be able to decrease misdiagnosis, improve patient outcome, and avoid liability.