Title: A Prospective Observational Study of Role of Modified Alvarado Score, Ultrasound Abdomen and Histopathology in the Diagnosis of Acute Appendicitis

Authors: Dr Sirikonda Srikanth, Dr Thogari Kranthi Kumar*, Dr K.S. Lakshmi Sri Vidya

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.180

Abstract

Appendicitis is the one of the most common surgical emergency with a lifetime risk of 8.6% in males and 6.7% in females. The diagnosis of acute appendicitis is predominantly based on clinical findings. When appendicitis manifests in its classic form, it is easily diagnosed and treated. This study tries to correlate between clinically diagnosed acute appendicitis and histopathologically examined specimen. In view of the above, it was decided to study the correlation between the combination of modified Alvarado score (MAS) and ultrasound in reducing negative appendicectomy rates and to determine the accuracy between them.

In our study we found that Ultrasonography and Modified Alvarado Score are both beneficial in diagnosis of acute appendicitis.

Keywords: appendicitis, modified Alvarado score (MAS), appendicectomy.

References

  1. Jan H, Khan J. evaluation of modified alvarado score in the diagnosis of acute appendicitis. 2007;23(4):4–6.
  2. Lone NA, Shah M, Wani KA, Peer GQ. Modified Alvarado Score in Diagnosis of Acute Appendicitis. Indian Journal for the Practising Doctor. Vol.3, No.2 (2006-06)
  3. Nautiyal H, Ahmad S, Keshwaniand NK, Awasthi DN. Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate. Indian Journal of    Surgery, Feb. 2010; Volume 72, Number 1, pp: 46-52.
  4. Al Qahtani HH, Muhammad AA. Alvarado score as an admission criterion for suspected appendicitis in adults. Saudi J Gastroenterol 2004; 10: 86-91.
  5. Lane MJ. Unenhanced helical CT for suspected acute appendicitis. Am J Roentgenol 1997;168:4059.
  6. Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:91025.
  7. Demircan A, Aygencel G, Karamercan M, Ergin M, Yilmaz TU, Karamercan A. Ultrasonographic findings and evaluation of white blood cell counts in patients undergoing laparotomy with the diagnosis of acute appendicitis. Ulus Travma Acil Cerrahi Derg 2010;16:24852.
  8. Dikicier E, Altintoprak F, Cakmak G, Degirmenci B, Akbulut G. The use of ultrasound imaging for acute appendicitis. Sakarya Med J 2011;2:646.
  9. Zielke A, Sitter H, Rampp T, Bohrer T, Rothmund M. Clinical decisionmaking, ultrasonography, and scores for evaluation of suspected acute appendicitis. World J Surg 2001;25:57884.
  10. Yamaner S. Diseases of the appendix. In: Degerli U, Bozfakioglu Y, editors. Surgical Gastroenterology 5. Edition Istanbul: Nobel Medikal Bookstore; 2000. p. 16876.
  11. Mentes O, Eryilmaz M, Yigit T, Tasci S, Balkan M, Kozak O, et al. Retrospectively analysis of appendectomies which performed elderly cases. J Acad Emerg Med 2008;4:3641.
  12. Chong CF, Thien A, Mackie AJ, Tin AS, Tripathi S, Ahmad MA, et al. Comparison of RIPASA and Alvarado scores for the diagnosis acute appendicitis. Singapore Med J 2011;52:3405.
  13. Limpawattanasiri C. Alvarado scora for the acute appendicitis in a provincial hospital. J Med Assoc Thai 2011;94:4419. [PUBMED]
  14. Jalil A, Shah SA, Saaig M, Zubair M, Riaz U, Habib Y. Alvarado scoring system
  15. Al Hashemy AM, Selem MI. Apprasial of the modified Alvarado score for acute appendicits in adults. Saudi Med J 2004;25:122931.
  16. Shrivastava UK, Gupta A, Sharma D. Evaluation of the Alvarado score in the diagnosis of acute appendicitis. Trop Gastroenterol 2004;25:1846.
  17. Terasawa T, Blackmore CC, Bent S, Kohlwes RJ. Systematic review: Computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents. Ann Intern Med 2004;141:53746.
  18. Wilson EB, Cole JC, Nipper ML, Cooney DR, Smith RW. Computed tomography and ultrasonography in the diagnosis of appendicitis when are they indicated ? Arch Surg 2001;136:6705.
  19. Orr RK, Porter D, Hartman D. Ultrasonography to evaluate adults for appendicitis: Decision making based on metaanalysis and probabilistic reasoning. Acad Emerg Med 1995;2:64450.
  20. Reich B, Zalut T, Weiner SG. An international evaluation of ultrasound vs. computed tomography in the diagnosis of appendicitis. Int J Emerg Med 2011;29:68.
  21. Yildirim E, Karagulle E, Kirbas I, Turk E, Hasdogan B, Teksam M, et al. Alvarado scores and pain onset in relation to multislice CT findings in acute appen-dicitis. Diag Interv Radiol 2008;14:148.
  22. Parks JS, Jeon JH, Lee JI, Lee JH, Park JK, Moon HJ. Accuracies of diagnostic methods for acute appendicitis. Am Surg 2013;79:1016.
  23. Puylaert JB. Acute appendicitis: US evaluation using graded compression. Radiology 1996;158:35560.

Corresponding Author

Dr Thogari Kranthi Kumar