Abstract
Objective: Acute appendicitis is one of the most common surgical emergencies around the world with Surgery for acute appendicitis is most frequent operation performed being 10% of all emergency abdominal operation. Removing of normal appendix is an economical burden both on patients and health resources. Misdiagnosing and delay in surgery can lead to complications like perforation and finally peritonitis.
Material & Methods: A prospective study was conducted in department of Surgery Jawahar Lal Nehru Medical College and Hospitals with a clinical diagnosis of acute appendicitis. The purpose of this study is to evaluate value of Alvarado score in 50 patients of right lower quadrant abdominal pain suspected as acute appendicitis.
Result: A total 50 patients operated for acute appendicitis on the application of Alvarado score.32 male and 18 female patients in this study. Pain present in all patient in RIF along with nausea, vomiting, anorexia. Almost all patients observed tenderness in RIF, 44% patients show leucocytosis.
Conclusion: To conclude that when the Alvarado score is more than 7, no false positive result obtained. Thus the application of Alvarado scoring system increases the sensitivity and specificity for diagnosis of acute appendicitis with the added advantages of being simple and easy to use.
References
- Stephens PL, Mazzucco JJ et al. Comparison of ultrasound and the Alvarado score for the diagnosis of acute appendicitis. Com Med. 1999 March; 63(3): 137-140.
- Cuschieri A. The small intestine and vermiform appendix; in Cuschieri A, GR Giles, AP Mossa. (Ed.). Essential Surgical Practice, 3rd Londan: Butter Worth Heinmann. 1995; 1325-8.
- Pal K.M. Khan A. Appendicitis, a continuing challenge. J Pak Med Assoc 1998; 48: 189-92.
- Kumar V, Cotran RS, Robbins SL. Appendix; in Robbins Basic Pathology. 5th edition London: W.B. Saunders 1992; 520.
- Addis DG, ShafferN, Fowler BS et al.: Epidemiology of appendicitis and appendicectomy in the United States. Am J Epidem 132: 910, 1990.
- Korner H. Soderoa K. Soreide JA, et al.: Incidence of acute non perforated and perforated appendicitis: Age specific sex specific analysis. World J. Surg. 21:313, 1997.
- Boyce FF. Acute appendicitis and its complications. C Publ. N.Y. Oxford Univ. Press, 1939.
- Campbell JA, Mephail DC. Appendicitis B.M.J. 1958; 1852.
- Alvarado A. A practical score for acute appendicitis. Ann Emerg Med. 1986 May; 15(5): 557-64.
- Buschard K. Kiaeldgaard A. Investigation and analysis of the posiyion , fixation, lengthand embryology of vermiform appendix. Acta Chir Scard 139; 293, 1973.
- Ajmani ML. Ajmani K: The position, length, and arterial supply of vermiform appendix. Anat Anz 153: 369; 1983.
- Skandalak’s JE, Gray SW, Rickens R: The colon and rectum in Skandalak’s JE, Gray SW: Embryology for surgeons. Baltimore, Williams and Wilkins 242; 1994.
- John H. Neffu et al. Schweizer Ischer Rundschwan for medicine Praxis 80 (43): 1173-1178; 1991.
- Chan MY, Ten BS, et al.: The Alvarado Score and acute appendicitis. Ann Acad Med Singapore 2001; Sept. 30(5): 510-2.
- Cronogorac S, Lorvenski J. Validation of the Alvarado score in the diagnosis of acute appendicitis. Med Preg. 2001 Nov. – Dec.54 (11-12): 557-61.
- Y.P. Chan, C. Tan. M.T. Chiu, Y.Y. Ng et al. Alvarado score: An admission criterion in patients with right iliac fossa pain. Surg JR Coll Surg Edinb Irel., 1 February 2003, 39-41.
- Denisbasi, Arzu; Unluer, Erol Erden. Et al.The role of emergency medicine residents using the Alvarado score in the diagnosis of acute appendicitis compared with general surgery residents. European journal of Emergency Medicine 10(4): 296-301 December 2003.
- Ikramullah Khan, Ata ur Rehman et al. Application of Alvarado scoring system in diagnosis of acute appendicitis. J Ayub Med Coll Abbortabad 2005; 17(3).
- Shrivastava UK, Gupta A, Sharma D. Evaluation of the Alvarado score in the diagnosis of acute appendicitis. Twp Gastroenterol 2004; Oct.- Dec.,25(4): 184-6.s
Corresponding Author
Dr Vishal Kumar Neniwal
3rd year Resident Surgery Dept. G.M.C. Kota
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile no. 9461879372