• Paxton Loke, Joselito Tantoco, Peter Ferguson, Yves Heloury, Chris Kimber, Ed Oakley, and Wei Cheng.
• Department of Paediatric Surgery, Monash Children's, Monash Medical Centre/Southern Health, 246 Clayton Road, Clayton, VIC 3168, Australia.
• Emerg Med Australas. 2012 Aug 1;24(4):414-9.

ObjectiveAppendicitis is the most common paediatric surgical emergency. In our institution, the majority of inter-hospital transfers are for suspected appendicitis. We undertook an audit to assess the accuracy of the provisional diagnosis of the transferred cases.MethodsRetrospective electronic data of a tertiary referral centre and a single referring regional hospital were collected between January 2009 and December 2010. Primary outcome of surgery, inpatient observation or discharge was assessed. The final appendix pathology results were examined.ResultsThere were 187 paediatric surgical transfers (49% by ambulance) that were provisionally diagnosed as appendicitis. Of the 187 patients (M : F = 102 : 85, a median age of 11), 70% were admitted, 43% underwent appendicectomy, and only 40% had pathologically proven appendicitis.ConclusionsOf the surgical referrals for appendicectomy, 60% did not have appendicitis. An improved assessment protocol is required to reduce the margin of diagnostic error and transfer cost, while maintaining clinical safety.© 2012 Monash Children's, Southern Health. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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