OBSERVATIONAL STUDY OF DIAGNOSTIC ACCURACY OF MODIFIED ALVARADO SCORE AND ULTRASONOGRAPHY IN ACUTE APPENDICITIS IN ADULTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 5
Abstract
BACKGROUND Vermiform appendix is a narrow, worm-shaped tube which springs from the posteromedial wall of the caecum. It participates in the secretion of immunoglobulin, particularly IgA. Acute appendicitis is the most common surgical emergency with an annual incidence in the USA of 9.38 per 100,000. Arriving at the correct diagnosis is essential; however, a delay may allow progression to perforation and significantly increased morbidity and mortality. Aims and Objectives- We aim to study the efficacy of Modified Alvarado Scoring system versus Ultrasonography in adults to decrease the number of negative appendectomies. MATERIALS AND METHODS The study “Observational Study of Diagnostic Accuracy of Modified Alvarado Score and Ultrasonography in Acute Appendicitis in Adults” is a prospective observational study, which comprised of 200 patients above the age of 16, admitted in the Department of Surgery, Government Medical College, Srinagar with a provisional diagnosis of Acute Appendicitis. Sensitivity, Specificity, Predictive value for Positive and Negative tests and Accuracy of each diagnostic modality were worked out and compared with histopathological outcome. RESULTS We found that Modified Alvarado Score had the best Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value. However, Specificity of Total Leukocyte Count was equal to that of Modified Alvarado, but it had the least sensitivity and accuracy. Ultrasonography has the highest accuracy, which was comparable to that of Modified Alvarado Score. Ultrasonography on the other hand had the least Specificity, Positive Predictive Value and Negative Predictive Value. CONCLUSION Modified Alvarado and ultrasonography should be used together in surgical emergency for diagnosing cases of acute appendicitis.
Authors and Affiliations
Varun Dogra, Shakeel Ahmad Mir, Syed Mushtaq Ahmad Shah, Ishfaq Ahmed Gilkar, Hanief Mohamed Dar5
Keywords
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- EP ID EP368922
- DOI 10.14260/jemds/2018/151
- Views 61
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