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By clicking register, I agree to your terms. All rights reserved. Design by w3layouts. A total of 57 studies were included in this study; of these, 14 described the way that the sign was executed. Additionally, 3 current English text books on surgery, 3 German text books on surgery, and 3 German books on anatomy were analyzed.
The descriptions in studies and books were compared with the original publication by Niels Thorkild Rovsing in None of the 3 English text books on surgery described the sign accurately, but all 6 German text books provided a correct description. All statistical data available on this sign must be questioned and reinvestigated in future well-designed studies to assess the actual value of Rovsing sign in the diagnosis of appendicitis. J in Surgery.
Published by Elsevier Inc. It more often affects younger individuals, with a peak in incidence between 10 and 30 years. To facilitate an accurate diagnosis, a wide variety of clinical signs have been described and subsequently studied over the years. Despite the fact that ultrasonography and computed tomography have become more readily and easily available, clinical examination remains the cornerstone of the diagnostic process and should not be neglected.
Because they are fairly self-explanatory and have mostly been around for more than years, the procedures are rarely questioned. In this study, the authors attempted to quantify the magnitude of the problem, analyze the different ways in which it is described, attempt to ascertain the reason for this misunderstanding, and subsequently urge clinicians to use the sign correctly from now on.
The original publication by Niels Thorkild Rovsing was retrieved from the archives of the medical school library. Important passages of the original publication were translated from German to English by one of the authors, and the translation was evaluated and approved by an independent translator. Studies original articles and reviews in both the English and German languages were included.
Graphical display of the literature research. Next, original articles and reviews for which the full text was not accessible by our institutional access i. Six studies were added after further citation research.
The included studies were read by both authors independently. The intention was to investigate whether students are already taught the incorrect way to elicit Rovsing sign and a possible reason behind the incorrect portrayal of this clinical examination.
They continuously described it as pain in the lower right quadrant after pressure or palpation of the lower left quadrant or left iliac fossa. This difference is also highlighted when examining a study from Yasui et al. The description of Rovsing sign in each English-language article. The goal of that study was to investigate the low prevalence of the sign also reported by Davey et al.
This forces gas into the caecum. The authors suspect a translational error. A translational error might also explain why the sign is described correctly in German books, in contrast to the English books. Subsequently, doctors have been applying the sign incorrectly, and studies published on this topic have been conducted on an erroneous basis.
Therefore, these studies were not considered for further analysis. An important question, however, involves practical applications on the basis of theory. As a consequence, and in accordance with an evidence-based approach to this clinical examination, we must admit that we are currently ignorant of its actual clinical value.
One possible weak point of this study is the fact that the authors could not investigate all research articles that would have been included in this study owing to their limited access to medical journals. Statistical data concerning this topic may largely be inaccurate. This study by design does not provide an answer to the question of whether Rovsing sign is helpful in clinical practice or whether the current data overestimate or underestimate its serviceability.
This study, however, may act as a reminder that it is important to question the so-called facts and data, even when they have been around for a long time, and may provide an impetus to initiate followup studies providing new data on Rovsing sign.
Bruch H-P, Trentz O. Berchtold Chirurgie. Vital Health Stat Series 13 ;Dec Bundesamt S. Diagnosedaten der Patienten und Lippert H. Lehrbuch Anatomie. Clinical prac- ed. Stuttgart: Thieme Georg Verlag; Stuttgart: Thieme; Loeweneck H, Feifel G.
Praktische Anatomie Bauch. Berlin: Springer Verlag; Suspected appendicitis. N Engl J Med. Yasui H. Br Med J. Diagnosis Davey WW. Clin Infect Dis. Results of the Wagner and Ilizarov methods of limb-lengthening. J Bone Joint Surg Am. McBurney CH. Experience with early operative inter- ference in cases of disease of the vermiform appendix. Lanz O. Zentralbl Chir. Blumberg M. Rovsing T. Ein Beitrag zur Diagnostik der appendicitis und typhlitis. Acute appendicitis: controversies in diagnosis and management.
Curr Prob Surg. Blackbourne LH. Surgical recall. North American edition. Sharma OP. Back to the basics. Bailey H, Clain A. Demonstrations of Physical Signs in Cl- inical Surgery.
Aird IA. Companion in Surgical Studies. World J Surg. Atypical clinical features of pediatric appendicitis. Acad Emerg Med. Comparison of clinical judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis: experience with a score-aided diagnosis.
Eur J Surg. J Anat. Pro- Essentials of General Surgery. Suggest Documents. Learning from erroneous examples in medical education. Evaluation of an online medical teaching forum. Research on cultivating medical students' self-learning ability using teaching system integrated with learning analysis technology.
Teaching neuroImages: Hyperdense posterior cerebral artery sign. On teaching about research in schizophrenia. Medical technology and research: an engineer's view. Erroneous abscess. A faculty-facilitated near-peer teaching programme: an effective way of teaching undergraduate medical students. Noreen Clark's five lessons on teaching, research, and mentoring. Twelve tips on teaching and learning humanism in medical education. Teaching video neuroimages: clonus of the lower jaw: an old sign that comes back.
Medical education teaching resources.
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Duale Reihe Chirurgie
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