Evaluation of Modified Alvarado Scoring System in Acute Appendicitis

Deebapriya, A P (2010) Evaluation of Modified Alvarado Scoring System in Acute Appendicitis. Masters thesis, Chengalpattu Medical College, Chengalpattu.


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INTRODUCTION: Acute appendicitis remains one of the most common surgical diseases encountered. When appendicitis manifests in its classical form it is easily diagnosed & treated. Unfortunately these classic symptoms occur in one half of patients with acute appendicitis. Accurate & timely diagnosis of atypical appendicitis remains clinically challenging and one of the most commonly missed problems in the emergency department. Furthermore the consequence of missing appendicitis thus leading to perforation significantly increases morbidity & prolongs hospitalization. AIM OF THE STUDY: To evaluate the value of Modified Alvarado Scoriing System (MASS) as a diagnostic tool to aid early and accurate diagnosis of acute appendicitis. MATERIALS AND METHODS: A prospective study was conducted from august 2007 to October 2009 in patients admitted with suspected acute appendicitis in the surgical wards of chengalpattu medical college hospital. Patients with suspected acute appendicitis were assessed by Modified alvarado scoring system. Age group comprised of 10 years to 70 Years. Both sexes were included. Patients included in the study were haemodynamically stable without any concurrent illness. Thorough clinical examination was done along with total leucocyte count. CONCLUSION: Modified Alvarado Scoring system with a diagnostic accuracy of 97% seems to be ideal for supporting the diagnosis of acute appendicitis because it is noninvasive, does not require special equipments, and is simple to remember, and use in a peripheral set up by a junior resident where radiological investigation are difficult to perform. The sensitivity and specificity of the test is good for the male population compared with the females. This can be easily attributed to the pelvic pathological conditions which require a diagnostic ultrasound in addition. In conclusion Modified Alvarado scoring along with an abdominal and pelvic ultrasound may be the ideal tool to diagnose acute appendicitis in males. Acute appendicitis is a common cause of abdominal pain in patients attending emergency departments. Nevertheless, a correct diagnosis based on Clinical and laboratory findings is not easy. Promising results have been published for the use of ultrasonography and to inquire the diagnostic accuracy. However, these investigations are highly investigator dependant or they involve exposure to radiation, respectively. History taking and physical examination on the other hand require no special equipment and are readily available. It is also conceivable that imaging techniques will gain wider acceptance, but careful history taking and clinical diagnosis are important measures. (i) Determining which patients would benefit from these investigation, and (ii) Providing the clinical contest that is necessary for correct interpretation of imaging findings.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Acute Appendicitis ; Modified Alvarado Scoring System.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 07 Jun 2018 04:05
Last Modified: 08 Jun 2018 01:28
URI: http://repository-tnmgrmu.ac.in/id/eprint/8284

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