Validating Alvarado scoring in the diagnosis of acute appendicitis

Mohammed Sikkander, S I (2014) Validating Alvarado scoring in the diagnosis of acute appendicitis. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: Acute Appendicitis is a common and sometimes confusing cause of acute abdomen at all age groups. Diagnosis of appendicitis can be difficult, occasionally taxing the diagnostic skills of even the most experienced surgeon. Despite increased use of USG, CT, the rate of misdiagnosis of appendicitis has remained the same (15.3%). OBJECTIVES: To review the usefulness of Alvarado score & to evaluate its feasibility and value as an aid in surgical decision making and to reduce the number of negative laparotomies. MATERIALS AND METHODS: 100 patients who were admitted to Government Royapettah Hospital from Jan 2013 to Dec 2013 with clinical suspicions of acute appendicitis were included in the study. The modified scoring system is based on 3 signs, 3 symptoms and 1 laboratory finding. The patient was classified as males, females and children (< 12 years). These were further grouped based on the scores 7 - 9, 5-6 and <5. OBSERVATION AND RESULTS: In our study 52 were males, 38 Females, 10 Children. Males with score 7-9 were 39. Females with score 7-9 were 14. Children with score 7-9 were 10. Males with score 5-6 were 08. Females score 5-6 were 18. Children Score 5-6 were 0. A total of 80 patients with score of 7-9 and 5-6 were operated. Among males with score of 7-9, 35 patients were operated and 34 were found to have inflamed appendix. Females with score 7-9, 16 were operated and 11 were found to have inflamed appendix. CONCLUSION: Alvarado score significantly reduces the number of negative laparotomies without increasing the overall rate of appendicular perforation. It is very effective in Men & Children but diagnostic laparoscopy or ultrasonography is advised to minimize the high false negative rate in women.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Appendicitis ; Negative appendectomy rate ; Clinical Score.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 06 Jul 2018 01:04
Last Modified: 06 Jul 2018 01:04

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