scholarly journals Role of modified Alvarado scoring system and USG abdomen in acute appendicitis: an overview

2017 ◽  
Vol 4 (12) ◽  
pp. 4029
Author(s):  
Rajkishore Singh ◽  
Rajiv Singh ◽  
Kulwant Singh
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Clinical Teaching ◽  
Research Centre ◽  
Medical Sciences ◽  
Alvarado Score ◽  
Major Procedure ◽  
Negative Appendicectomy ◽  
Modified Alvarado Score

Background: Acute appendicitis is the most common cause of an ‘acute abdomen’ in young adults and, as such, the associated symptoms and signs have become a paradigm for clinical teaching. Appendicitis is sufficiently common that appendicectomy (termed appendectomy in North America) is the most frequently performed urgent abdominal operation and is often the first major procedure performed by a surgeon in training. In this study we correlate the usefulness of Modified Alvarado scoring system(MASS) and ultrasonography(USG) in management of acute appendicitis.Methods: The study was done on 60 patients of symptomatic appendicitis, requiring management accordingly, attending surgical OPD of People’s College of Medical Sciences(PCMS) and Research Centre, Bhopal, India from 1st October 2011 to 30th August 2013. The study includes 60 patients between 5-60 yrs of age. They were prospectively evaluated on admission using the modified Alvarado Score to determine whether or not they had acute appendicitis, all equivocal cases were subjected to ultrasonography examination. The score and ultrasonography were correlated with the operative and histological findings.Results: All 60 patients underwent surgery. The sensitivity of the modified Alvarado score was 89.65% and sensitivity of USG was 91.37%, out of 60 cases of acute appendicitis male were 36 and remaining 24 cases were female. So, it showed sex ratio of 36:24, 3:2 which correlate with literature and other studies. With use of both MASS and USG as diagnostic tool, out of 60 cases 57 cases were positive and with the help of histopathology, it was confirmed in 58 cases.Conclusions: The modified Alvarado scoring system is a good diagnostic indicator for acute appendicitis. It helps in minimizing the rates of negative appendicectomy. It can be used as an adjunct to surgical decision-making along with ultrasonography in doubtful cases. When combined, modified Alvarado score and ultrasonography can work very effectively in diagnosing acute appendicitis(AA) correctly and in reducing the number of negative appendicectomy.

scholarly journals Incidence of negative appendicectomy, our experience of 100 patients at Sir Ganga Ram Hospital Lahore

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Muhammad Aslam ◽  
Ayesha Shaukat ◽  
Farid Zafar ◽  
Amir Riaz Bhutta ◽  
Aftab A Choudhri ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Clinical Examination ◽  
Scoring System ◽  
Iliac Fossa ◽  
Age Groups ◽  
International Studies ◽  
Alvarado Score ◽  
History Of ◽  
Negative Appendicectomy ◽  
Modified Alvarado Score

Background: Despite recent advances in diagnostic medicine, the diagnosis of Acute Appendicitis is still doubtful in a number of cases. Majority of the Clinicians rely on their clinical examination, strengthened by the laboratory tests. This study was done to see the incidence of negative appendicectomy in Patients, who presented in surgical emergency with pain in Rt. Iliac fossa. These patients were assessed and evaluated by clinical examination as well as with the help of Modified Alvarado Scoring system and surgery was decided accordingly. Aims and Objective: To see the incidence of Negative appendicectomies at Sir Ganga Ram Hospital, Lahore and comparing the rate with the rate of other international Studies. Study Design: It was a prospective clinical and Pathological study, consisting of 100 patients, presenting in the Sir Ganga Ram Hospital Lahore, with history of right iliac fossa pain. Material and Method: One hundred patients were included in the study, and diagnosis of acute appendicitis was bas ed on Clinical Examination and Modified Alvarado Score. The patients selected for this study were of all age groups and both sexes. Out of hundred, 56 patients were operated after being assessed by clinical Examination and Modified Alvarado Scoring System. Results: The incidence of negative appendicitis was about 7% in male, 20% in female and about-10% in children. Conclusion: Over all the rate of negative appendicectomies was 15%, which is with in lower limit of the other international studies.

scholarly journals Clinico-pathological and etiological evaluation of acute appendicitis and assessment of significance of laboratory and ultrasonography examination as an ancillary aid to clinical diagnosis

2019 ◽  
Vol 6 (6) ◽  
pp. 1954
Author(s):  
Sailendra Nath Paul ◽  
Dilip Kumar Das
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Scoring System ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Complication Rates ◽  
Alvarado Score ◽  
Negative Appendicectomy ◽  
Operative Findings

Background: Timely diagnosis and intervention of acute appendicitis reduces morbidity and mortality associated with the disease condition. The study aimed to evaluate the etiology of acute appendicitis, to analyze the sensitivity of modified Alvarado scoring system and radiology in the diagnosis of acute appendicitis and to correlate the observations of laboratory tests, operative findings with the histopathological report of specimen of appendix.Methods: This was a prospective study done on 100 patients with clinical symptoms of acute right lower abdominal pain suggestive of appendicular origin during the period from February 2015 to January 2016 in the department of surgery thorough clinical assessment, laboratory investigations, ultrasound findings as were done for all patients. After confirming the diagnosis of AA the patients had operative intervention and specimens were sent for histopathological study.Results: Male preponderance was seen in the study. Majority of them belongs to 21 to 30 years age group (50%). Faecolith was the most common etiological factor observed (58%). Abdominal pain (100%) was the most common clinical symptom. Alvarado score had sensitivity of 95.74% and specificity of 66.67% in diagnosing AA. In correlation to histopathological findings, ultrasonography findings showed 100% positive visualization rate in all 71 cases. Elevated ESR (94%) had high diagnostic accuracy as confirmed by HPE finding (96.81%) which is statistically significant (p<0.000).Conclusions: Alvarado scoring system, elevated ESR levels and USG findings of the appendix can be considered as adjuncts to clinically diagnose the AA, to improve the diagnostic accuracy thereby consequently the rate of negative appendicectomy can be reduced and thus decreases the complication rates.

scholarly journals Comparative study between clinical diagnosis using modified Alvarado score and ultrasound imaging in decreasing negative appendectomy rate

2021 ◽  
Vol 8 (4) ◽  
pp. 1185
Author(s):  
Sayali S. Samudre ◽  
Anil S. Munde
Keyword(s):  
Acute Appendicitis ◽  
Comparative Study ◽  
Ultrasound Imaging ◽  
Health Resources ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Negative Appendicectomy ◽  
Modified Alvarado Score ◽  
Operative Findings ◽  
Fitting In

Background: Acute appendicitis is the acute inflammation of appendix which is the most common cause of acute surgical emergencies. Appendicitis can mimic other pathologies. Removing normal appendix is an economical burden both on patients and health resources. Misdiagnosis and delay in surgery can lead to complications like perforation and finally peritonitis.Methods: This was prospective comparative study carried out in 200 patients over the period of 2 years. Patients with clinical features of acute appendicitis and fitting in inclusion and exclusion criteria were selected. Detailed history was noted and clinical examination was done. Necessary investigations were done, modified Alvarado score was calculated and all were subjected to ultrasonography of abdomen and pelvis. Intra operative findings were noted about nature of appendix and histopathology findings were noted.Results: The sensitivity of ultrasound is 78.19% and specificity is 50%. The sensitivity of modified Alvarado scoring system is 78.7% and specificity is 25%. Negative appendicectomy rate in the study was 6%.Conclusions: Modified Alvarado score has slightly higher sensitivity and ultrasound imaging has higher specificity of in the diagnosis of acute appendicitis and in decreasing negative appendicectomy rates. Ultrasound imaging provides good supportive diagnosis in cases of low or equivocal modified Alvarado scores.

scholarly journals Evaluation of modified Alvarado scoring system in acute appendicitis at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

2017 ◽  
Vol 4 (7) ◽  
pp. 2118
Author(s):  
Punjala Sai Rithin ◽  
Aman Agarwal ◽  
Bhavana Budigi
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Scoring System ◽  
Iliac Fossa ◽  
Research Centre ◽  
Negative Appendectomy ◽  
Common Symptom ◽  
Complication Rates ◽  
Medical Sciences ◽  
Male Predominance

Background: Despite of much advancement in modern diagnostic technology, decision making in patients with acute appendicitis is still a challenge worldwide. Many diagnostic scoring systems have been developed. Of them modified Alvarado scoring system (MASS) has been reported to be a cheap and quick diagnostic tool which minimizes negative appendectomy rate. The present study was aimed to evaluate the efficacy of MASS in diagnosing acute appendicitis and correlating the same with histopathological results.Methods: This prospective cohort study conducted from November 2012 to April 2014, over a period of 18 months at Vydehi Institute of Medical Sciences and Research Centre, Bangalore. 100 patients with symptoms of acute appendicitis were enrolled in the study. They were diagnosed using MASS. Patients with a score of 7 to 10 were taken up for surgery. Patients with a score below 7, but with high suspicion of acute appendicitis by the surgeon were taken up for surgery. Following surgery all appendix specimens were sent for histopathologic examination.Results: A total number of 100 patients were participated in the study. Of them patients under the age group of 21-30 years were more affected with acute appendicitis (51%). Male predominance was observed in the study (74%). The common symptom observed in all patients (100%) was tenderness in right Iliac fossa (RIF). Out of 100 patients, 79% of the patients were presented with a modified Alvarado score of ≥7 and 21% presented with a score of <7. The sensitivity and specificity of the MASS in this study was 89.66% and 92.31% in both males and females respectively. The positive predictive value was 98.73%, negative predictive value was 57.41% and the NAR was 6.75% and 30.76% in male and female patients respectively.Conclusions: The observations of the study confirm that use of MASS in patients suspected to have acute appendicitis provides a high degree of diagnostic accuracy and subsequently reduces the negative appendicectomy and complication rates.

scholarly journals Modified alvarado score in diagnosis of acute appendicitis: a clinicopathological study

2018 ◽  
Vol 5 (3) ◽  
pp. 878
Author(s):  
Sanjay Jain ◽  
Ajay Gehlot ◽  
M. C. Songra
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Alvarado Score ◽  
Diagnostic Modality ◽  
Delay In Diagnosis ◽  
Modified Alvarado Score

Background: Acute appendicitis is one of the commonest surgical emergencies in all ages. Diagnosis is mainly clinical, delay in diagnosis definitely increases the morbidity, mortality and cost of treatment, more aggressive surgical approach has resulted in increased white appendectomies.Methods: A total 100 cases hospitalized with abdominal pain, suggestive of acute appendicitis on the basis of modified Alvarado scoring system and were subsequently operated, were included in the present study in our institute for period of 20 Months.Results: Males belonging to young age group of 21-30 were most commonly affected. Abdominal pain was seen in 100% of patients. Fever seen in 87% of patients and vomiting in78%. Modified Alvarado score of 9 had positive predictive value of 100% while negative predictive value 8.9%, while score between 7-8 had positive predictive value of 98.9% and negative predictive value 27.8%. The sensitivity was 86.1% and specificity was 83.3%. The ultrasonography showed a sensitivity of 94.68%. In present study rate of total white appendectomy was 6%. The Modified Alvarado scoring system is a reliable and practicable diagnostic modality to increase the accuracy in diagnosis of acute appendicitis and thus to minimise unnecessary appendectomy.Conclusions: Young males are most commonly affected almost always presents with abdominal pain. The Modified Alvarado scoring system is a reliable and practicable diagnostic modality to increase the accuracy in diagnosis of acute appendicitis and thus to minimise unnecessary appendectomy.

scholarly journals Role of Modified Alvarado Score in the Diagnosis of Acute Appendicitis

2014 ◽  
Vol 13 (10) ◽  
pp. 44-48
Author(s):  
Dr Pradeep Goyal ◽  
◽  
Dr Arvind Kanwar ◽  
Dr Parikshit Malhotra ◽  
Dr Dhruv Sharma ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Alvarado Score ◽  
Modified Alvarado Score

scholarly journals A COMPARATIVE STUDY OF TZANAKIS SCORE VS ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPEDICITIS

2020 ◽  
pp. 39-41
Author(s):  
Shouryabrata Choudhury ◽  
Bhaskar Sharma ◽  
Neelanjana Paul
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Scoring System ◽  
Open Appendectomy ◽  
Scoring Systems ◽  
Alvarado Score ◽  
Duration Of Symptoms ◽  
Medical College ◽  
Negative Appendicectomy ◽  
Sensitivity Specificity

Background: Acute appendicitis is the most common cause of sudden abdominal pain requiring surgery. Prolong duration of symptoms before the surgical intervention increases the risk of morbidity and mortality due to perforation. There have been several scoring systems to help the decision making process to reach diagnosis of acute appendicitis. ALVARADO and modified ALVARADO are the two most commonly used system worldwide. This study is being done to assess the accuracy of the TZANAKIS SCORING SYSTEM and ALVARADO SCORING SYSTEM in the diagnosis of acute appendicitis and reduce the rate of negative appendicectomy. Methodology: This was a hospital based prospective observational study conducted on patients admitted in the Department of General Surgery, Silchar Medical college and Hospital. This study was based on the analysis of 100 patients diagnosed to have acute appendicitis and underwent emergency open appendectomy from March 1st ,2020 – August 31st 2020. Aims and objectives: The aim of the present study is to assess the compare the accuracy of TAZANAKIS Scoring system and ALVARDO scoring system in the diagnosis of acute appendicitis. Results: The sensitivity, specificity, positive predictive value and negative predictive value of Tzanakis score was 83.72, 78.57, 96.0 and 44.0 respectively and of Alvarado score was 65.11, 35.71, 86.1 and 14.28 respectively. Negative appendicectomy was 14%. Conclusion: Tzanakis scoring system is an effective scoring system to establish the accurate diagnosis of acute appendicitis and helps in reducing negative appendicectomy rate.

scholarly journals Clinicopathological evaluation of acute appendicitis and the role of ultrasound in diagnosis: a prospective study

2019 ◽  
Vol 6 (5) ◽  
pp. 1471
Author(s):  
Tony Mathew ◽  
Amit Shivshankar Ammanagi
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Lower Abdominal Pain ◽  
Negative Appendicectomy ◽  
A Prospective Study

Background: Acute appendicitis is the most common acute surgical condition of the abdomen. Delay in treatment of acute appendicitis causes lot of complication. Study was done with the objective to study the clinical and pathological presentations of acute appendicitis, to evaluate the role of ultrasound in early diagnosis of acute appendicitis and to reduce negative appendicectomy in patients.Methods: This is a prospective study done on 100 patients with acute right lower abdominal pain clinically presumed to be of appendicular origin. A thorough history, clinical examination and ultrasound scan, was done for all cases. All ultrasound positive cases were subjected to surgery and some negative cases were also taken for surgery based on clinical suspicion. The ultrasound diagnosis was compared with clinical findings, operative findings and histopathological examination reports.Results: The overall accuracy of clinical diagnosis (Alvarado scoring system) with histopathology findings was 72%. The overall sensitivity and specificity was 70.3% and 81.3% respectively and positive predictive value of was 95.2% whereas the negative predictive value was 34.2%. The overall accuracy of ultrasound with histopathology report was 93%, with a sensitivity of 96.4%, specificity of 75%, and a positive predictive value of 95% and a negative predictive value of 80%. Negative appendicectomy rate was 8.82% in females and 3.63% in males.Conclusions: The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and inexpensive way of confirming acute appendicitis thus reducing negative appendicectomy rate.

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