Background: Acute appendicitis is a common condition encountered by a surgeon. If left untreated it can have severe morbidity and can lead to morbidity. Symptoms of acute appendicitis mimic a number of other conditions making it difficult to accurately diagnose. This study aims to use Alvarado scoring and ultrasound abdomen to diagnose acute appendicitis and reduce negative appendectomy rates.
Methods: The study was a prospective observational study conducted in the Department of General Surgery, Sree Gokulam Medical College and Research Foundation. The study constituted of 80 consecutive patient who was above the age of 14 and underwent surgery and gave consent for the study. The patients were assessed by clinical examination, Alvarado score and an ultrasound abdomen. The results of histopathology were compared with the Alvarado score and ultrasound abdomen and their accuracy was assessed.
Results: The majority of patients in this study were males with 80% being in the 14-29 year age group. Ultrasound proved conclusive in predicting appendicitis 37(50%) of 80 patients with a sensitivity of 50, specificity of 16.7 and an accuracy of 47.5. ALVARADO score was more than or equal to 7 in 70(88.8%) cases. The sensitivity was 94.6 and was specificity 83.3. The predictive value of the positive test with ALVARADO Score was 98.6, with 93.8% accuracy. Combining ALVARDO score and ultrasound abdomen negative appendectomy rate was found to be 7.5% in our study.
Conclusion: The aim of this study was to evaluate the use of the ALVARADO score and USG abdomen in diagnosing acute appendicitis. Clinical assessment is the mainstay of diagnosis with ALVARADO score and ultrasound significantly contributing to the more efficient diagnosis and reduction in negative laparotomies.
Key words: Alvarado score, ultrasound abdomen, negative appendicectomy, acute appendicitis
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