A Prospective Study To Evaluate Alvarado Score In Acute Appendicitis

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A Prospective Study To Evaluate Alvarado Score In Acute Appendicitis

Journal Title: National Journal of Medical and Dental Research - Year 2018, Vol 6, Issue 4

Abstract

The present study has been conducted in Departments of Surgery and Pathology, S.N. Medical College & Hospital, Agra during a period from January 2011 to October 2012. Out of 47 patients 25 were males and 22 were females. There is preponderance of males over females. Appendicitis is common in younger age group (11-30 yr) 74.47% in both sexes. Appendicitis is rare in extremes of ages (children & old) in both sexes. Rate of negative appendicectomy in the study is 17.02%. Rate of negative appendicectomy in males is 12.0%. Rate of negative appendicectomy in females is 22.72%. Pain in right lower abdomen is the most consistent symptom & is present in all patients. Pain migration from periumbilical area to right lower quadrant is the second most common symptom followed by nausea, vomiting and fever. Mc Burney sign is the most common sign elicited. Psoas sign is the least common sign among patients. Migratory right iliac fossa pain is the most common symptom of Alvarado scoring system and is present in 31 patients. Right iliac fossa tenderness is the most common sign elicited of Alvarado scoring system and is present in 45 patients. Leucocytosis is present in 35 patients of appendicitis. Total 8 patients having Alvarado score 5 or <5 out of which 3 (37.50%) were negative for appendicitis on histopathological examination. Total 30 patients having Alvarado score 6-8 out of which 26 (86.67%) were positive for appendicitis on histopathological examination. Total 9 patients having Alvarado score 9-10 out of which 8 (88.89%) were positive for appendicitis on histopathological examination. Among 47 patients of clinically suspected appendicitis, 39(82.97%)patients were positive for appendicitis on abdominal Ultrasonography. 2 patients were negative for appendicitis and 6 patient’s reports were inconclusive. Among 39 patients, who were positive for appendicitis by Ultrasonography, 37 were positive for appendicitis on histopathological examination. Over all negative appendicectomy rate in our study is 23.40%. In patients having Alvarado Score 6 or >6 the negative appendicectomy rate is 12.82%. In Patients operated having USG reports positive for appendicitis, the rate of the negative appendicectomy rate is 5.13%. No imaging studies are needed in patients with classic appendicitis.

Authors and Affiliations

Manoj Agrawal, Atrey Garg

Keywords

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