MRI as First Line Imaging for Suspected Acute Appendicitis during Pregnancy: Diagnostic Accuracy and level of Inter-radiologist Agreement

2021 ◽  
Author(s):  
Bestoun Ahmed ◽  
Jon Williams ◽  
William Gourash ◽  
Jun Zhang ◽  
Runjia Li ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
First Line ◽  
Line Imaging ◽  
Suspected Acute Appendicitis

scholarly journals Diagnostic accuracy of combining C-Reactive protein and Alvarado Score among 2-to-20-year-old patients with acute appendicitis suspected presenting to Emergency Departments

2021 ◽  
Author(s):  
Kinda Altali Alhames ◽  
Francisco Javier Martín-Sánchez ◽  
Pedro Ruiz-Artacho ◽  
Francisco Javier Ayuso ◽  
Victoria Trenchs ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Emergency Departments ◽  
Low Risk ◽  
C Reactive Protein ◽  
Alvarado Score ◽  
Old Patients ◽  
Reactive Protein ◽  
Surgical Data ◽  
Suspected Acute Appendicitis

Objective. Main objective was whether the combination of C-Reactive Protein (CRP) and Alvarado Score (AS) increase the diagnosis accuracy of AS among 2-to-20-year-old patients with suspected acute appendicitis presenting to Emergency Departments. Materials and methods. This is a secondary analysis of prospective cohort study consecutively including all patients from 2 to 20 years of age attended for suspected acute appendicitis in 4 Spanish Emergency Departments during 6-month period. We collected demographic, clinical, analytic and radiographic, and surgical data. AS categories were retrospectively calculated as low (0-4 points), intermediate (5-6 points) or high (7-10 points). The cut-off levels were >0.5 mg/dl for CRP. The outcome was diagnosis of acute appendicitis within 14 days of the index visit. Results. A total of 331 patients with suspected of acute appendicitis (mean age 11.8 (SD 3.8) years; 52.9% males) were recruited. According to AS, 108 (32.6%) were at low risk, 76 at (23.0%) intermediate risk and 147 (44.4%) at high risk of acute appendicitis. One hundred and sixteen (35.0%) cases had confirmed histopathological diagnosis of acute appendicitis. The AUCs of ROC were 0.76 (0.70-0.81) for AS and 0.79 (95% CI 0.75-0.84) for CRP-AS being the difference statistically significant (p=0.003). The CRP for diagnosis acute appendicitis in low risk AS group had negative predictive value of 95.8% (95%CI 87.3-98.9) and likelihood ratio negative of 0.4 (95%CI 0.2-1.0). Conclusions. CRP-AS has shown to increase the diagnostic accuracy of AS for acute appendicitis. This approach may be useful to rule out the diagnosis of acute appendicitis in paediatric patients attended for abdominal pain suggestive of acute appendicitis.

scholarly journals A three year prospective study-suspected acute appendicitis: diagnostic accuracy of modified Alvarado score versus ultrasonography in adults

2017 ◽  
Vol 4 (12) ◽  
pp. 3924
Author(s):  
Murhari D. Gaikwad ◽  
Anand Auti ◽  
Avinash Magare
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Prospective Study ◽  
Predictive Value ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Modified Alvarado Score ◽  
Suspected Acute Appendicitis

Background: To evaluate and compare diagnostic accuracy of modified Alvarado score and ultrasonography in co-relation to histopathology report for diagnosis of acute appendicitis.Methods: A prospective study of the patients who underwent appendectomy for suspected acute appendicitis at IIMS and R Medical College and Noor Hospital Warudi, Badnapur, Dist. Jalna (Maharashtra). The clinical (radiological) and ultrasonography data of 760 patients with suspected appendicitis was collected between March 2014 to Feb. 2017. These patients were evaluated by modified Alvarado score and ultrasonographically, which was corrected with histopathological finding.Results: Out of 760 patients 69.34% had acute appendicitis 63.81% had modified Alvarado score≥7 and 58.28% patients were ultrasonographically positive. In present study modified Alvarado score has sensitivity of 89.37% specificity 93.99% positive predictive value 97.11%, negative predictive value 79.64%, diagnostic accuracy of 81.32%.Conclusions: Modified Alvarado score can be used effectively in clinical decision making. When compare with ultrasonography neither one is advantageous. However, additional information provided by ultrasonography improves diagnostic accuracy.

The Value of Scoring Systems for the Diagnosis of Acute Appendicitis

2015 ◽  
Vol 87 (2) ◽  
Author(s):  
Dominik A. Walczak ◽  
Dariusz Pawełczak ◽  
Agata Żółtaszek ◽  
Rajmund Jaguścik ◽  
Wojciech Fałek ◽  
...  
Keyword(s):  
Data Analysis ◽  
Acute Appendicitis ◽  
Hospital Admission ◽  
Diagnostic Accuracy ◽  
Scoring Systems ◽  
Diagnostic Value ◽  
Accurate Diagnosis ◽  
Normal Appendix ◽  
Detailed Medical History ◽  
Suspected Acute Appendicitis

AbstractAccurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies.The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis.Material and methods. The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results.Results. Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively).Conclusions. Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis

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