Comparative Study between Modified Alvarado Score and Abdominal Ultrasound Diagnostic Value of Acute Appendicitis in Children

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.

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Diagnosis of Acute Appendicitis using Modified Alvarado Score and Abdominal Ultrasound

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2018/34611.11417 ◽

2018 ◽

Author(s):

Aabhas Mishra ◽

Sukumar Santosh Kumar ◽

Anamika Sinha

Keyword(s):

Acute Appendicitis ◽

Abdominal Ultrasound ◽

Alvarado Score ◽

Modified Alvarado Score

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Comparative Study of Diagnostic Accuracy of Modified Alvarado Score and Ultrasonography in Acute Appendicitis

IOSR Journal of Dental and Medical Sciences ◽

10.9790/0853-13173640 ◽

2014 ◽

Vol 13 (1) ◽

pp. 36-40 ◽

Cited By ~ 7

Author(s):

Dr. Satyajeet Kr Singh ◽

Dr. Kunal Kr Singh ◽

Dr. Chitrangada Singh ◽

Prof. Dr Subrata Nag

Keyword(s):

Acute Appendicitis ◽

Comparative Study ◽

Diagnostic Accuracy ◽

Alvarado Score ◽

Modified Alvarado Score

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Assessment of the accuracy of using the combination of modified alvarado score and abdominal ultrasound in acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20173678 ◽

2017 ◽

Vol 4 (9) ◽

pp. 2997

Author(s):

Anita Samraj ◽

Dharun Kumar S.

Keyword(s):

Acute Appendicitis ◽

Histopathological Examination ◽

Iliac Fossa ◽

Diagnostic Delay ◽

Abdominal Ultrasound ◽

The Body ◽

Total Leucocyte Count ◽

Alvarado Score ◽

Combined Use ◽

Modified Alvarado Score

Background: Appendix is a worm shaped blind tube of varying length (2-25) cm opening into the caecum 2cm below the ileocaecal valve in posteromedial valve. It is the only organ in the body that has no constant position. Incidence of acute appendicitis parallels that of lymphoid development with peak incidence in early adulthood. It is rare before the age of two. Before puberty the incidence of acute appendicitis is equal in both sexes. But after puberty there is a slight male preponderance. The objective of this study was to evaluate assessment of accuracy of the combined use of modified Alvarado scoring system and ultrasound in the diagnosis of acute appendicitis.Methods: Around 136 patient’s acute appendicitis were subjected to estimation of total leucocyte count and plain x-ray abdomen after thorough history evaluation and clinical examination before surgery. Alvarado score was found in all cases. All of them were operated on the day of admission itself and preoperative findings were noted. All appendicectomy specimens were subjected to histopathological examination (HPE).Results: Acute appendicitis is the most common surgical abdominal emergency in our hospital. Acute appendicitis is more common in males and the commonest age group affected is 21 - 30 years. Right iliac fossa pain is the most common presenting symptom followed by nausea/vomiting. In diagnosis of acute appendicitis Alvarado score has a high diagnostic value (82.5%).Conclusions: The combined use of modified Alvarado score with ultrasonogram done in patients with equivocal or low Alvarado score is useful in identifying the missed-out cases thereby preventing diagnostic delay and its attendant complications. Appendices that appear to be normal on macroscopic inspection may show features of acute appendicitis on histopathologic examination.

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Augmentation of modified Alvarado score with abdominal ultrasound in diagnosis of acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20205408 ◽

2020 ◽

Vol 8 (1) ◽

pp. 111

Author(s):

Shipra Sharma ◽

Ankit Soni ◽

Sanjay Kumar ◽

Manoj Poptani

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

Abdominal Ultrasound ◽

Laboratory Findings ◽

Alvarado Score ◽

Surgical Emergencies ◽

Increased Sensitivity ◽

Negative Appendicectomy ◽

Modified Alvarado Score ◽

Sensitivity Specificity

Background: Acute appendicitis is one of the commonest surgical emergencies. But confirming the diagnosis of acute appendicitis is still a subjective issue for clinicians. Modified Alvarado score is based on clinical and laboratory findings which is scored upto 9. Management of 5 to 7 modified Alvarado score came under equivocal. Either may be conservative or operative.Methods: We augmented the modified Alvarado score with abdominal ultrasound in diagnosis of acute appendicitis.Results: Outcomes were evaluated in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and negative appendicectomy rate, results of our study are sensitivity 95.7%, specificity is 76.92%, PPV 93.75% and NPV 33.34%.Conclusions: Overall increased sensitivity, specificity, NPV and PPV of the augmented approach is useful for diagnosis of acute appendicitis which scored under 5-7 of modified Alvarado scoring system.

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Augmentation of modified Alvarado score with abdominal ultrasound in diagnosis of acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20200833 ◽

2020 ◽

Vol 7 (3) ◽

pp. 853

Author(s):

Manoj Poptani ◽

Ankit Soni ◽

Shipra Sharma ◽

Sanjay Kumar

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

Abdominal Ultrasound ◽

Laboratory Findings ◽

Alvarado Score ◽

Surgical Emergencies ◽

Increased Sensitivity ◽

Negative Appendicectomy ◽

Modified Alvarado Score ◽

Sensitivity Specificity

Background: Acute appendicitis is one of the commonest surgical emergencies. But confirming the diagnosis of acute appendicitis is still a subjective issue for clnicians. Modified Alvarado score is based on clinical and laboratory findings which is scored upto. Management of 5 to 7 modified Alvarado score came under equivocal. Either may be conservative or operative.Methods: We augmented the modified alvarado score with abdominal ultrasound in diagnosis of acute appendicitis.Results: Outcomes were evaluated in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and negative appendicectomy rate, results of our study are sensitivity 95.7%, specificity is 76.92%, PPV 93.75% and NPV 33.34%.Conclusions: Overall increased sensitivity, specificity, NPV and PPV of the augmented approach is useful for diagnosis of acute appendicitis which scored under 5-7 of modified alvarado scoring system.

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