Title: Evaluation of Modified Alvarado Score and Ultrasonography for the Diagnosis of Acute Appendicitis at Tertiary Care Hospital in Western Rajasthan
Authors: Samay Singh, Ashok Kumar, Diwan Jakhar, Dharmveer
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.17
Abstract
Background: Acute appendicitis is most common cause of pain abdomen. The diagnosis of which remain difficult in many cases.
Methods: A 100 consecutive patients suspected of acute appendicitis who were admitted in department of surgery, sardar patel medical college & AGH, Bikaner, Rajasthan. They were prospectively evaluated using the modified Alvarado scoring (MAS) to determine whether or not they had acute appendicitis. The MAS was correlated with USG and histopathological findings.
Results: 78 (true positive) patients who had MAS 7 or more had appendicitis on histopathology while no patients (false positive) had a normal appendix; 15(false negative) patients with MAS less than 7 had appendicitis and 7(true negative) had a normal appendix removed.
Conclusion: The MAS should be combined with USG for the diagnosis of acute appendicitis. But nothing can replace careful evaluation by an experienced surgeon.
Keywords: Modified Alvarado Score (MAS), Acute appendicitis, false positive.
References
- Jones PF. Suspected acute appendicitis: trends in management over 30 years. Br J surg2001; 88:1570-1577.
- Lee SL, Walsh AJ, Ho HS, computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis. Arch surg2001; 136:556-561.
- Talukder DB and Siddiq AKMZ. Modified Alvarado scoring system in the diagnosis of acute appendicitis. JAFMC Bangladesh 2009; 5(1):18-20.
- Ongaro, Neford. Evaluation of the usefulness of modified Alvarado scoring system regarding early diagnosis of acute appendicitis and in reduction of negative appendicectomy at Kenyatta National hospital. A prospective study. M med dissertation, Dept of Surgery, University of Nairobi 2005 .
- Ohle ,Robert., O'Reilly, F., O'Brien, K., K., et al. The Alvarado score for predicting acuteappendicitis: a systematic review. BMC Medicine 2011, 9:139.
- Saidi, H.5., Chavda, S.K., Use of a modified Alvarado score in the diagnosis of acute appendicitis. East Afr Med 2003 Aug; 80(8):411-414.
- Kimaro,S. Correlation of ultrasound, clinical and surgical findings of suspected acute appendicitis in KNH. MMed dissertation .Universlty' of Nairobi 2011 .