Rectal Examination

Patients may also be tender on digital rectal examination. There is evidence to suggest that the finding of a painful rectal exam is of little benefit with positive and negative predictive values of 0.44 and 0.54 respectively [6]. Certainly multiple rectal examinations should be avoided in patients with suspected appendicitis.

Learning bite

Appendicitis largely remains a clinical diagnosis based upon piecing together the history and examination.