Evaluation of modified alvarado score in diagnosis of acute appendicitis in adults

Selvan, R (2015) Evaluation of modified alvarado score in diagnosis of acute appendicitis in adults. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

BACKGROUND: The most common surgical emergency in the world is Acute Appendicitis. Inspite of greater than hundred years of experience, diagnosis of acute appendicitis still evades the surgeon, Negative appendicectomy rate is been 20% to 30% as reported. Surgeons are using various scoring systems to diagnose and operate the cases. AIM OF THE STUDY: Aim of study is to evaluate use of “Modified Alvarado score” in diagnosis of “Acute Appendicitis” to reduce unwanted appendicectomies. METHODOLOGY: A study of 100 patients presenting with abdominal pain and provisionally diagnosed as acute appendicitis were taken. A score was calculated for each case based on Modified Alvarado score. Patients with score between 5-9 were operated and < 5 treated conservatively. Ultrasonogram was done in all patients with score > 5 to rule out other diagnosis mimicking acute appendicitis. After surgery the appendix specimen was sent for histopathological examination and was correlated with the clinical presentation. Hence results of operative, conservative and HPE reviewed. RESULTS AND OBSERVATION: In this study females were more in number with a ratio of 1.2 : 1 with females. The result of this study showed that score (7-9) had a sensitivity of 95% in males, in females had sensitivity of 88.46%. The score (5-6) in men & females had a sensitivity of 73.91% and 65.38% respectively. INTERPRETATION AND CONCLUSION: The high scores in Modified Alvarado score is dependable aid in the early diagnosis of “Acute Appendicitis” in men but it is not true as far as women are concerned. Ultrasonography of abdomen is a useful tool in avoiding negative appendicectomy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Acute Appendicitis ; Aid to Diagnosis ; Modified Alvarado Score ; Sensitivity.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 06 Oct 2018 03:45
Last Modified: 06 Oct 2018 03:45
URI: http://repository-tnmgrmu.ac.in/id/eprint/9672

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