Correlation between Alvarado Score and Intra-Operative Findings In Acute Appendicitis

Abstract

Background: acute appendicitis remains the most common abdominal surgical emergency in both developing and developed countries, appendectomy considered as most frequent operation performed, the diagnosis of acute appendicitis still a surgical dilemma due to wide range of differential diagnosis, that’s why many diagnostic scores had been developed to reduce the rate of unnecessary appendectomy and to avoid post-operative complications of unnecessary surgery, also to reach accurate diagnosis and to avoid missed cases.

Aim of study: to evaluate sensitivity, specificity and accuracy of Alvarado score in pre-operative diagnosis of acute appendicitis.

Setting: Al-Yarmuk Teaching Hospital / Department of Surgery.

Patients and Methods: a prospective study of 225 patients whom were admitted to the department of surgery as emergency cases from Jan.2019 to Jan. 2020. Data were collected for each patient included age, gender, duration of pain, past medical and surgical history, temperature, leucocyte count, abdominal ultrasound, general urine examination, type of an aesthesia, intraoperative findings and post-operative complications, all data were analyzed by Alvarado score.

Results: the majority of cases were in the age group (11-20) 98 patients (43.6%), with accurate intra-operative diagnosis of acute appendicitis (88.89%) after using the Alvarado score in the diagnosis pre-operatively. The negative appendectomy rate was 27 cases (12.0%) which lies within the worldwide range of other studies.

Conclusion: the Alvarado score can be applied easily in a simple way by junior as well as senior doctors to reach accurate diagnosis of acute appendicitis in cases of right iliac fossa pain, to reduce the rate of unnecessary surgery.