Comparative study between modified Alvarado score and abdominal ultrasound in the diagnosis of acute appendicitis

Abstract

Aim & Objective: To compare the accuracy of modified Alvarado score and ultrasonography in the diagnosis of acute appendicitis to reduce the morbity and mortality from appendicitis and also reduce the negative appendicectomy rates Methodology: This study was undertaken in 100 patients with a provisional diagnosis of acute appendicitis getting operated in Prathima Institute of Medical Sciences, Karimnagar from November 2016 to October 2018. Modified Alvarado score and USG findings were applied in the preliminary diagnosis, which was confirmed by intra operative and histopathological findings. Results: Fifty five patients were females and forty five were males. There was no statistical significance in the male to female ratio. The highest incidence (37%) was found in the age group of 21-30 and the lowest (4% each) was seen in the age group of 51-60 & 61 & above respectively. Ninety nine patients presented with anorexia and tender RIF. Ninety eight patients had migratory RIF pain. Nausea & vomiting, rebound tenderness, and leucocytosis were seen in 58, 53 and 39 patients respectively. Only 27 patients had elevated temperature. Forty three patients had a score of >7 out of which 42 had appendicitis and 1 was normal on histopathological examination which contributed to 97.7% and 2.3% of the patients respectively. Sensitivity, specificity and accuracy of MAS was 44.6%, 83.3%, 47% respectively. Sixty one patients were found to have appendicitis by USG out of which 60 had appendicitis and 1 was normal on histopathological examination, with a sensitivity of 63.8% and a specificity of 83.3% & accuracy 65%. Ninety four patients were diagnosed to have appendicitis by histopathological examination and 6 were reported to be normal. Accuracy of ultrasound to diagnose acute appendicitis was 65% and MAS was 47%.