An Accurate Early Diagnosis of Acute Appendicitis by Clinical Scoring and Ultrasonography Reduces Complications

Aim: To evaluate combined use of Alvarado score& ultrasonography in diagnosing ac. appendicitis. Methods: This cross-sectional study was conducted from 1 st January 2013 to 31 st August 2013 at S. Z. Hospital, Lahore in the Department of General Surgery & 250 patients having acute appendicitis who presented through out-patient and accident & emergency departments were included. Results: The mean age was 35.17±9.13. 184(74%) were males and 66 (26%) were females with a male to female ratio 1.92:1. 174(70%) patients had anorexia while 76(30%) patients had no symptoms of anorexia. Nausea and vomiting in 124(49.6%) patients while 126(50.4%) had no symptoms of nausea and vomiting. Rebound tenderness was in 236(95%) patients. 8(3%) patients had score 5 possible appendicitis in these patients. 13(5%) patients had score 6. 127(51%) patients had 7-8 score in this group and appendicitis likely. 102(41%) patients had score 9-10, in this score appendicitis highly likely. On ultrasonography, 230(92%) patients had appendicitis and only 20(8%) had no appendicitis on ultrasonography. According to histopathology finding, there were 241(96%) patients of acute appendicitis and 9(4%) patients had gangrenous, normal and chronic appendicitis. Conclusion: The application of this scoring system along with noninvasive ultrasonography improves diagnostic accuracy (92%) and consequently reduces negative appendicectomy (8%).

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