scholarly journals ACUTE APPENDICITIS;

2014 ◽  
Vol 21 (06) ◽  
pp. 1139-1143
Author(s):  
Zahid Saeed
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Acute Abdomen ◽  
Carcinoid Tumour ◽  
Diagnostic Tools ◽  
Associated Conditions ◽  
Proper Diagnosis ◽  
Negative Appendicectomy ◽  
Appendiceal Inflammation ◽  
Time Of Presentation

Background: Acute appendicitis is the commonest cause of acute abdomen presenting in emergency room, which is mainly diagnosed on clinical grounds. Objective: To determine the diagnostic accuracy in patient of acute appendicitis and to review the pathological diagnosis. Material and Method: A retrospective study was conducted at PNS SHIFA hospital at Karachi; from May 2012 to April 2013. A total of 120 patients were included in the study who presented with acute abdomen and clinically diagnosed as acute appendicitis. Emergency appendectomy was done in all consecutive subjects and intra operative finding along with histo-pathological reports were compared with clinical diagnosis. Results: A total of 120 patients were included in the study who underwent appendicectomy during this period. The majority of our patients were in the age group between 15-30 years (66.5%) and presented within 24 h of onset of symptoms. The most common symptoms were abdominal pain (100%), vomiting (57.4%) and anorexia (49.0%). Pyrexia was noted in 41.0%.Localized abdominal tenderness with positive release sign was mainly present. The most common incision was gridiron (57.2%) followed by Lanz (37.3%) and in remaining Rutherford Morrison incision was made. Acute appendiceal inflammation and gangrenous appendicitis was present in 67% and 13%, respectively. The perforation rate was 5.0% and there was a direct correlation with time of presentation. There were no patients with carcinoid tumour or adenocarcinoma. Parasites and other associated conditions were seen in 3 % of cases. On the basis of histo-pathological report, 84% were found to have acute appendicitis with negative appendicectomy rate of 16.0%. Conclusions: Clinical surgical skill is good enough to diagnose acute appendicitis but auxiliary diagnostic tools can help to elevate the diagnostic accuracy,but these are not 100% accurate and at times may not be available.So clinial good judgement is essential for proper diagnosis and that can be confirmed by histopathology report.

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

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 353 AIR Score Based Management of Appendicitis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Carlile
Keyword(s):  
Acute Appendicitis ◽  
Ct Scan ◽  
Acute Abdomen ◽  
General Surgery ◽  
Diagnostic Laparoscopy ◽  
Open Appendicectomy ◽  
Common Cause ◽  
Retrospective Audit ◽  
Negative Appendicectomy ◽  
Score Risk

Abstract Introduction Appendicitis is the most common cause of an acute abdomen. Approximately 7% of the population will be affected at some point. The development of AIR has been developed to aid diagnosis and decreasing the number of negative appendectomies while also safely identifying those who have developed appendicitis. Aim This retrospective audit, which aims to assess the effects of the introduction of AIR score risk on the negative appendicectomy rate of patients admitted to Taranaki Base Hospital. Method All patients under General Surgery receiving open appendicectomy, laparoscopic appendicectomy or diagnostic laparoscopy for evaluation or treatment of appendicitis from January 1st 2017 – December 31st 2018. Results The negative appendicectomy rate dropped 11.1% after introduction of the AIR score, we also noted a decrease in CT scan use. Discussion Our results suggest that the Air score could be used as an adjunct to the clinical diagnosis of acute appendicitis.

scholarly journals Treatment outcomes of Acute Appendicitis and associated factors among admitted patients with a diagnosis of Acute Abdomen in Debre Markos referral hospital, Amhara region, North West Ethiopia

2019 ◽  
Author(s):  
Abebe Dilie Afenigus ◽  
Agumas Mossie Bayieh ◽  
Berhanu Kassahun
Keyword(s):  
Treatment Outcome ◽  
Acute Appendicitis ◽  
Treatment Outcomes ◽  
Acute Abdomen ◽  
Associated Factors ◽  
Referral Hospital ◽  
Appendiceal Abscess ◽  
Debre Markos ◽  
Wbc Count ◽  
Time Of Presentation

Abstract Introduction- Acute abdomen is a sudden onset abdominal disease condition which often requires an immediate surgical intervention. Appendicitis is an inflammation of the vermiform appendix and is one of the most common causes of an acute abdomen in young adults. Appendicitis can cause severe periumbilical pain that radiates to the right lower quadrant, nausea, vomiting and anorexia. If left untreated, it can also cause appendiceal abscess, perforation and peritonitis. Objective - To assess treatment outcomes of Acute Appendicitis and associated factors among admitted patients with a diagnosis of acute abdomen in Debre Markos referral hospital from September 11/2018 to March 9/2019. Methods and materials - Institutional based cross sectional study was employed among 169 patients using a census sampling method. Data were collected from patient medical records, registration books and anesthesia charts available in the hospital by using checklist. Data was entered using Epi-data version 4.2 and analyzed by SPSS version 25 software. Logistic regression analysis was employed to describe the relationship between outcome and predictor variables. Results - Among 303 patients with a diagnosis acute abdomen, 169(55.7%) were developed acute appendicitis, of whom, 107(63.7%) were males and 62 (36.7%) were females. Among 169 patients who underwent appendectomy for treatment of acute appendicitis, 45(26.6%) of them were developed unfavorable treatment outcomes. The odds of unfavorable treatment outcomes for acute appendicitis was higher among patients who had elevated WBC count at the time of presentation [AOR=4.7; 95% CI (1.95, 11.35)] as compared with their counterparts. Similarly, those patients who had an intraoperative appendiceal abscess were more likely to have unfavorable treatment outcome for acute appendicitis [AOR= 3.8; 95% CI (1.61, 9.07)] as compared to those who didn’t have appendiceal abscess. Conclusion and recommendation- Nearly one-fourth of patients who underwent appendectomy for appendicitis treatment were developed unfavorable treatment outcomes. Elevated WBC count at the time of presentation and presence of intraoperative appendiceal abscess were the factors associated with unfavorable treatment outcome of acute appendicitis. Therefore, immediately evaluate patients having similar features with laboratory investigations is crucial.

scholarly journals Incidence of Negative Appendicectomy: Correlation Between Clinical, Peroperative and Histopathological Findings

2017 ◽  
Vol 42 (3) ◽  
pp. 142-146
Author(s):  
Mohammad Zillur Rahman ◽  
Johirul Islam ◽  
Md. Hasanuzzaman ◽  
Ahsan Habib ◽  
Avisak Bhattachari
Keyword(s):  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Reproductive Age ◽  
Histological Evaluation ◽  
Diagnostic Tools ◽  
Histopathological Findings ◽  
Suspected Appendicitis ◽  
Female Patients ◽  
Male Patients ◽  
Negative Appendicectomy

Appendicitis is one of the most difficult diagnostic problems to confront the emergency physician and it is the most common intra-abdominal condition requiring emergency surgery. The term “Negative appendicectomy” used for operation done for suspected appendicitis, in which the appendix is found to be normal on histological evaluation. The study aimed to find out the incidence of negative appendicectomy evaluating the correlation between clinical, per-operative and histopathological findings. It was a prospective study of 100 cases clinically diagnosed as acute appendicitis selected over a period of one year (July 2006 to June 2007) from different surgical ward of Mymensingh Medical College Hospital. The study revealed a negative appendicectomy rate of 12%. Moreover, in all cases of acute appendicitis, there was a well established bias towards male patients and young male patients constituted the majority of the cases. But the rate of negative appendicectomy found to be higher in female patients, which is 15.9% as compared to only 8.92% male patients. In addition, among female patients differential diagnostic difficulties encountered in females of reproductive age group. More emphasis on technology at the expense of clinical evaluation is certainly responsible for the diminish in accuracy of diagnosis. The diagnosis of acute appendicitis remains essentially clinical, requiring a mixture of observation, clinical acumen and accurate use of diagnostic tools.  A correct diagnosis is certainly important than a rapid diagnosis.

Another Look at Acute Appendicitis in Tropical Africa: And the Value of Laparoscopy in Diagnosis

1993 ◽  
Vol 23 (2) ◽  
pp. 82-84 ◽  
Author(s):  
B C Ogbonna ◽  
P O Obekpa ◽  
J T Momoh ◽  
J T Ige ◽  
C H Ihezue
Keyword(s):  
Decision Making ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Clinical Decision Making ◽  
Acute Abdominal Pain ◽  
Clinical Decision ◽  
Tropical Africa ◽  
Increased Risk ◽  
Negative Appendicectomy

Acute appendicitis is believed to be one of the commonest causes of the acute abdomen in tropical Africa. Negative appendicectomy rates are usually above 20%, which is now considered unacceptably high because of increased risk to patients and the availability of diagnostic facilities to aid clinical decision-making. Our negative appendicectomy rate over a 4-year retrospective period was 29.7% in males, and 47% in females. These reduced to 11 % and 10%, respectively, after the introduction of laparoscopy for doubtful cases of acute abdominal pain.

scholarly journals Negative laparotomy rates in acute abdomen: a declining trend

2016 ◽  
Vol 4 (1) ◽  
pp. 323 ◽  
Author(s):  
Geeta Sabhnani ◽  
Shreya Tomar
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Acute Abdomen ◽  
Common Finding ◽  
Emergency Setting ◽  
X Ray ◽  
Negative Laparotomy ◽  
Preoperative Diagnostic ◽  
Operative Findings ◽  
Accuracy Rates

Background:A prospective observational study of 105 operated cases of non-traumatic acute abdomen in emergency setting in tertiary government hospital was carried out. The correlation between preoperative diagnostic, radiological and clinical assessment and operative findings was noted. The clinical and radiological diagnostic accuracy rates were calculated using descriptive statistical analysis. Negative laparotomy rates were calculated and compared to the previous studies.Methods: The most common finding was acute appendicitis and the most frequently involved age group was 21-40.The absence of correlation between preoperative diagnosis and operative findings was noted in 7 cases of which 2 cases of appendicitis had been missed on ultrasound and 2 cases of appendicular mass were reported as acute appendicitis where appendectomy could not be done on account of adhesions.2 cases of x-ray diagnosed obstruction with clinical features of vomiting ,constipation had no gross bowel pathology on laparotomy while one case diagnosed preoperatively as appendicitis turned out to be a case of renal colic with hydroureter.Results:The diagnostic accuracy rate of x-ray and ultrasound for obstruction/perforation and acute appendicitis were found to be 89.79% and 94.64% respectively.Conclusions:The negative laparotomy rates were low around 2.85%.

scholarly journals Comparison of RIPASA and Alvarado score in diagnosing acute appendicitis

2019 ◽  
Vol 6 (3) ◽  
pp. 740
Author(s):  
Suraj S. Kagwad ◽  
P. Karuppasamy
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Scoring System ◽  
Cost Effective ◽  
Clinical History ◽  
Alvarado Score ◽  
Negative Appendicectomy ◽  
Sensitivity Specificity ◽  
Ripasa Score

Background: Acute appendicitis is a common cause of abdominal pain and can be difficult to diagnose, especially during its early stages.  The diagnosis of acute appendicitis is based on clinical history, examination combined with investigations. The purpose of this study is to compare between the RIPASA score and Alvarado score in the diagnosis of acute appendicitis. The aim of the present study was to compare the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado and RIPASA score.Methods: The cases for the study will be sourced from cases admitted in SVMCH and RC, Puducherry during the period of November 2016 to June 2018.Results: Out of the 144 patients in our study 133 patients were diagnosed with acute appendicitis as per HPE report.As per our study, sensitivity, specificity, PPV, NPV of RIPASA and Alvarado scoring system is 96.2%, 57.1%, 97.7% and 44.4%; 81.9%,85.7%, 95.1% and 20%  respectively. The diagnostic accuracy of RIPASA score is 94.3 as compared to 82.1 of Alvarado score.Conclusions: The RIPASA scoring system is a promising and has good sensitivity, specificity and diagnostic accuracy when compared to Alvarado scoring for Asian Population.RIPASA scoring system is an easy and reliable, cost effective diagnostic tool which reduce negative appendicectomy rates and the expensive radiological investigations for the diagnosis of acute appendicitis.

Sign in / Sign up

Export Citation Format

Share Document