Evaluation of concordance among surgeons and pathologists regarding the diagnosis and classification of acute appendicitis in children

Study of 1092 pediatric appendectomy cases reveals only moderate concordance (kappa 0.7) between surgeons' intraoperative assessment and pathologists' histological classification of perforated versus non-perforated appendicitis. Diagnostic agreement was independent of surgeon experience or surgical approach, with minimal clinical impact from discordant cases.