Role of modified Al-varado score in diagnosis of acute appendicitis

Abstract

Objective: To evaluate the efficacy of modified Alvarado score in diagnosis of acute appendicitis and to correlate it with the operative and histopathalogical findings. Background: Acute appendicitis is a common surgical emergency which, even with modern diagnostic finding remain a challenging task for general practitioners and the surgeons ,various scoring system and imaging techniques have been used for diagnosis but still clinical assessment remains the corner stone for diagnosis. Methods: The study was conducted on 240 patients who were operated upon for acute appendicitis ,preoperatively modified Alvarado score was assigned to all, and the results were compared with operative and histopathalogical diagnosis. Patients were categorized in to three groups: Group1 clinically typical with Modified Alvarado score ≥7,154 patients. Group2 clinically doubtful with Modified Alvarado score(5-6),78 patients. Group 3,with score <5 ,8 patients. Setting: Al-fallujha general Hospital,Talib Al-janabi private Hospital -AL-fallujah- Anbar governorate-Iraq. Results: 88 out of 90 males with an Alvarado score of ≥ 7 and 52 out of 64 females with similar score had acute appendicitis which was post -operatively confirmed by operative finding and histopathological examination,41 males out of48 with a score of <7 and 26 females out of 38 with a similar score had appendicitis. Conclusion: Modified Alvarado score works well in males with more than 7 score, However high negative appendectomy rates are observed in females even with a score exceeding 7. © EuroJournals Publishing, Inc. 2012.