Title: Diagnostic Efficacy of Ripasa Scoring in Acute Appendicitis: A Tertiary Care Centre Study

Authors: Anilkumar S, Anilkumar A V, Shijina K, Unnikrishnan Govinda

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i1.142

Abstract

Background: appendicitis is one of the most common surgical conditions attended by young surgeons worldwide in emergency room. To diagnose appendicitis accurately, needs good clinical acumen, keen observing power and Surgical practice. Due to failure in in diagnosing appendicitis accurately mainly due to pitfalls in scoring systems followed all around the world we  conducted this study to find out the usefulness of RIPASA scoring system in diagnosing acute appendicitis compared to the histopathological findings as the gold standard.

Materials and Methods: All patients presenting to the casualty department in the department of surgery and paediatric surgery with right iliac fossa pain with clinical suspicion of acute appendicitis were eligible for the study. Patients of all age groups were included.

Result: The results of our study shows that RIPASA scoring with a cut off at 7.5 will help differentiating acute appendicitis which needs emergency appendicectomy from other conditions.

Discussion: The sensitivity and specificity of RIPASA scoring in diagnosing acute appendicitis in our study was 0.93 and 0.67 when the cut off for RIPASA was fixed at 7.5 as suggested by the ROC analysis.

Keyword: appendicitis, ripasa score, histopathology.

References

11.      Storck A, Rothschild JE, Ochsner A. Intestinal obstruction due to intraluminal foreign bodies. Annals of surgery. 1939;109(5):844.

2.      Narsule CK, Kahle EJ, Kim DS, Anderson AC, Luks FI. Effect of delay in presen-tation on rate of perforation in children with appendicitis. The American journal of emergency medicine. 2011;29(8):890-3.

3.      Flum DR, Morris A, Koepsell T, Dellinger EP. Has misdiagnosis of appendicitis decreased over time? A population-based analysis. JAMA: the journal of the American Medical Association. 2001;286 (14):1748-53.

4.      Jawaid M, Raza SM, Alam SN, Manzar S. On-call emergency workload of a general surgical team. Journal of Emergencies, Trauma and Shock. 2009;2(1):15-8.

5.      Chong CF, Thien A, Mackie AJ, Tin AS, Tripathi S, Ahmad MA, et al. Comparison of RIPASA and Alvarado scores for the diagnosis of acute appendicitis. Singapore Med J. 2011;52(5):340-5.

6.      Reich B, Zalut T, Weiner SG. An international evaluation of ultrasound vs. computed tomography in the diagnosis of appendicitis. International Journal of Emergency Medicine. 2011;4:68-.

7.      Erdem H, Cetinkunar S, Das K, Reyhan E, Deger C, Aziret M, et al. Alvarado, Eskelinen, Ohhmann and Raja IsteriPengiranAnakSaleha Appendicitis scores for diagnosis of acute appendicitis. World journal of gastroenterology : WJG. 2013;19(47):9057-62.

8.      Sitter H, Hoffmann S, Hassan I, Zielke A. Diagnostic score in appendicitis. Valida-tion of a diagnostic score (Eskelinen score) in patients in whom acute appendicitis is suspected. Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie. 2004;389(3):213-8.

9.      Horzic M, Salamon A, Kopljar M, Skupnjak M, Cupurdija K, Vanjak D. Analysis of scores in diagnosis of acute appendicitis in women. Collegium antropologicum. 2005;29(1):133-8.

10.  Ohmann C, Yang Q, Franke C. Diagnostic scores for acute appendicitis. Abdominal Pain Study Group. The European journal of surgery = Actachirurgica. 1995;161(4) :273-81.

11.  Patnaik V, Singla RK, Bansal V. Surgical incisions—their anatomical basis Part IV-abdomen. J Anat Soc India. 2001;50(2):170-8.

Corresponding Author

Unnikrishnan Govindan

Assistant Professor, Dept of Surgery, Government Medical College, Thiruvananthapuram,

Kerala, India Pin: 695011

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., phone: 9961794443