scholarly journals RIPASA versus Alvarado score in the assessment of suspected appendicitis in children: a prospective study

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Tülin Öztaş ◽  
Muhammet Asena
Keyword(s):  
Acute Appendicitis ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Alvarado Score ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Right Lower Quadrant ◽  
Ripasa Score

Abstract Background Diagnosis of acute appendicitis remains a problem in children with right lower quadrant pain. Challenging diagnosis and fears of missing an inflamed appendix may lead to a negative appendectomy. Many scoring systems have been developed to reduce ambiguities in the diagnosis of appendicitis. Alvarado is one of the most commonly used scoring methods in pediatric patients. The RIPASA score is considered to be a better diagnostic scoring method in adults compared to Alvarado. The present study aims to compare RIPASA and Alvarado scoring systems in determining the possibility of acute appendicitis in children with right lower quadrant pain. This study included 179 consecutive pediatric patients who were referred to pediatric surgery with suspicion of acute appendicitis. The cut-off value was >7.5 for the RIPASA score vs. ≥7 for the Alvarado score. The possibility of appendicitis was divided into three groups for the Alvarado score and four groups for the RIPASA score. Results In this study, 158 of 179 patients were operated on. In 140 of the operated patients, the diagnosis of appendicitis was confirmed by histopathology. The negative appendectomy rate was 11.4%. Specificity and negative predictive value of RIPASA score were higher than those of Alvarado (p<0.001). No difference was found between the two scores concerning sensitivity, positive predictive value, and the area under the receiver operator characteristics curve (p>0.05). Conclusion The RIPASA scoring system can be used as an alternative to the Alvarado scoring system in the management of patients with right lower quadrant pain in emergency services and pediatric outpatient clinics. With the use of the RIPASA score, more patients with a low likelihood of appendicitis can be detected and further contributed to the reduction of the negative appendectomy rate.

scholarly journals Predictive value of scoring systems for the diagnosis of acute appendicitis in emergency department patients: Is there an accurate one?

2019 ◽  
Vol 27 (5) ◽  
pp. 262-269
Author(s):  
Rohat Ak ◽  
Fatih Doğanay ◽  
Ebru Unal Akoğlu ◽  
Haldun Akoğlu ◽  
Aslı Bahar Uçar ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Acute Appendicitis ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Acute Inflammatory Response ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Right Lower Quadrant

Background: Acute appendicitis is one of the challenging surgical conditions presented in the emergency departments. Clinical scoring systems were developed to reduce the negative appendectomy rate and also to avoid unnecessary diagnostic evaluation. Objectives: The primary aim was to compare the clinical adequacy of the Alvarado, Acute Inflammatory Response, and the Raja Isteri Pengiran Anak Saleha Appendicitis scores in patients with right lower quadrant pain for the diagnosis of acute appendicitis. Methods: This was a prospective and observational study. All patients over the age of 18 years who presented with a complaint of right lower quadrant pain were enrolled. The Alvarado, Acute Inflammatory Response, and Raja Isteri Pengiran Anak Saleha Appendicitis scoring systems were compared. The patients were either admitted or followed-up as out-patient. Face-to-face or telephone follow-up visits were arranged for the patients who did not have surgery and who were not admitted. Results: 232 patients were included and 14 patients were excluded from the study. Of the 218 patients, 114 patients underwent surgery. Of the 114 patients, 107 patients were pathologically diagnosed with acute appendicitis. It was determined that Raja Isteri Pengiran Anak Saleha Appendicitis score was the most valuable score with 0.88 accuracy, followed by Acute Inflammatory Response (area under the curve = 0.79) and Alvarado (area under the curve = 0.71) scores. Conclusion: The accuracy of Raja Isteri Pengiran Anak Saleha Appendicitis scoring system was higher for the diagnosis of acute appendicitis than the other scores. The cut-off of the Raja Isteri Pengiran Anak Saleha Appendicitis score from a 7.5-point threshold provides a practical, non-invasive, rapid diagnostic method that increases acute appendicitis discriminative power in patients presenting with right lower quadrant pain.

scholarly journals Systematic review of blunt abdominal trauma as a cause of acute appendicitis

2010 ◽  
Vol 92 (6) ◽  
pp. 477-482 ◽  
Author(s):  
Zaher Toumi ◽  
Anthony Chan ◽  
Matthew B Hadfield ◽  
Neil R Hulton
Keyword(s):  
Systematic Review ◽  
Acute Appendicitis ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Presenting Symptoms ◽  
Right Lower Quadrant

INTRODUCTION Acute appendicitis commonly presents as an acute abdomen. Cases of acute appendicitis caused by blunt abdominal trauma are rare. We present a systematic review of appendicitis following blunt abdominal trauma. The aim of this review was to collate and report the clinical presentations and experience of such cases. SUBJECTS AND METHODS A literature review was performed using PubMed, Embase and Medline and the keywords ‘appendicitis’, ‘abdominal’ and ‘trauma’. RESULTS The initial search returned 381 papers, of which 17 articles were included. We found 28 cases of acute appendicitis secondary to blunt abdominal trauma reported in the literature between 1991 and 2009. Mechanisms of injury included road-traffic accidents, falls, assaults and accidents. Presenting symptoms invariably included abdominal pain, but also nausea, vomiting and anorexia. Only 12 patients had computed tomography scans and 10 patients had ultrasonography. All reported treatment was surgical and positive for appendicitis. CONCLUSIONS Although rare, the diagnosis of acute appendicitis must be considered following direct abdominal trauma especially if the patient complains of abdominal right lower quadrant pain, nausea and anorexia. Haemodynamically stable patients who present shortly after blunt abdominal trauma with right lower quadrant pain and tenderness should undergo urgent imaging with a plan to proceed to appendicectomy if the imaging suggested an inflammatory process within the right iliac fossa.

scholarly journals Acute appendicitis: is it a seasonal disease?

2021 ◽  
Vol 8 (11) ◽  
pp. 5196
Author(s):  
Yasir Babiker Elshambaty ◽  
Saleh A. Alzahrani ◽  
Talal A. AlOmari ◽  
Waleed S. Shahwan ◽  
Abdullah A. Alzahrani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Abdominal Ultrasound ◽  
Operative Management ◽  
Rural Hospital ◽  
Histological Diagnosis ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Right Lower Quadrant

Background: The aim of this study was to review the management of acute appendicitis in a rural hospital. It was generally reported to be more common in men. Appendicitis is the most common surgical cause of abdominal pain worldwide. Appendectomy is the lonely curative treatment of appendicitis.Methods: This was a retrospective study in which we reviewed the records of the patients who had been diagnosed and operated on for appendicectomy from January to December 2017 in a rural hospital. The data were analyzed with SPSS version 25.Results: The total number of the patients was 114. About 69.3% are males. The mean age was 25.11 years. About (39.5%) were above 20 years old. Most of the cases presented in the period between January and March (27.3%). Right lower quadrant pain was the most common presenting symptom (93.9%). Nausea and vomiting mentioned by 57 (50%) and 74 (64.9%) of the participants respectively, fever in 42 (36.8%), muscle guarding in 0.9%, tenderness in 44 (38.6%), abdominal ultrasound was requested in 96 (84%). The most common histological diagnosis was acute suppurative appendicitis with peri-appendicitis in 15 (13.2%). All the cases were treated with open appendicectomy.Conclusions: We concluded that male are more affected with acute appendicitis. The most common presenting symptom was right lower quadrant pain. The vast majority of the cases were in the winter. Ultrasound has been used in the most cases particularly in male more than in females. The most common histological diagnosis was acute suppurative appendicitis. Open appendicectomy is the main operative management in our pts.

scholarly journals A Case of Postpartum Thrombophlebitis of a Retroperitoneal Varix Mimicking Acute Appendicitis

2019 ◽  
Vol 35 (5) ◽  
pp. 432-437
Author(s):  
Paula Glackin ◽  
Lars G. Crabo
Keyword(s):  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Ovarian Vein ◽  
Quadrant Pain ◽  
Sonographic Examination ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
The Right ◽  
Right Lower Quadrant

A case of thrombophlebitis of a retroperitoneal varix in a postpartum patient with right lower quadrant pain is presented. The sonographic examination was falsely positive for appendicitis, but the correct diagnosis was made with a subsequent computed tomogram. The thrombosed varix was likely a collateral of the right ovarian vein, analogous to postpartum ovarian vein thrombophlebitis (POVT), an uncommon potentially fatal disorder. POVT is reviewed, emphasizing features useful for distinguishing it from appendicitis at sonography. Sonographers should be aware of the possibility of thrombophlebitis when examining postpartum patients with right lower quadrant pain.

scholarly journals Uncommon Caecum Diverticulitis Mimicking Acute Appendicitis

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Özkan Yilmaz ◽  
Remzi Kiziltan ◽  
Vedat Bayrak ◽  
Sebahattin Çelik ◽  
Iskan Çalli
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Right Lower Quadrant

Diverticulum of the cecum is a rarely seen reason of acute abdomen and it is difficult to be distinguished from appendicitis. The diagnosis is generally made during operation. We have presented this case in order to remember that it is a disease which should be kept in mind in cases of right lower quadrant pain.

scholarly journals Cecal Endometriosis Presenting as Acute Appendicitis

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Hamidreza Alizadeh Otaghvar ◽  
Mostafa Hosseini ◽  
Ghazaal Shabestanipour ◽  
Adnan Tizmaghz ◽  
Gandom Sedehi Esfahani
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Right Colon ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Right Iliac Fossa Pain ◽  
Right Lower Quadrant

The aim of our paper is to show the diagnosis of Coecal endometriosis as an infrequent reason of right iliac fossa pain. cecal endometriosis manifesting with right lower quadrant pain is difficult to diagnose, and it may even sometimes require laparotomy for diagnosis and treatment. We report here a case of cecal endometriosis causing clinically resembled acute appendicitis. In our patient, a diagnosis of cecal endometriosis was made postoperatively by microscopic examination of excised right colon, and the patient symptoms and general condition were improved after the surgery (open right hemicolectomy and ileocolic anastomosis).

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