To evaluate the diagnostic accuracy of alvarado score, C-reactive protein, ultrasonography and computed tomography in acute appendicitis and to correlate them with operative and histological findings

Abstract

Background:Despite extraordinary advances in modern radiology and laboratory investigations an accurate diagnosis of acute appendicitis cannot be made in atypical cases. No single diagnostic aid can dramatically reduce the rate of negative appendicectomy.Methods: To reduce the rate of negative appendicectomies by the combined use of diagnostic modalities in a prospective study from July 2011 to December 2012 was done. 100 patients with right lower quadrant abdominal pain fulfilling the inclusion and exclusion criterion underwent appendicectomy in Mahatma Gandhi Medical College and Hospital, Jaipur, India.Results:The results of the diagnostic aids were reported in combination using the ‟or” rule and were correlated with intraoperative and histopathological findings. Chi-square test was applied to calculate the p value for the association between the variables of studied. The mean age was 26±11.25 years (10-59 years) and there were 70 males and 30 females in the study. Histopathological examination confirmed appendicitis in 90 patients with 10 negative appendicectomies. A negative appendicectomy rate of 5.71% in men and 20% in women was observed.Conclusions:Alvarado score in combination with ultrasonography is a valuable tool for diagnosing acute appendicitis inspite of sophisticated investigations like CT, thus reducing the cost of treatment and preventing negative appendicectomy rate.