The place of ultrasonography and alvarado scoring system in the diagnosis of acute appendicitis

Abstract

Aim: We investigated the predictive value of Alvarado scoring system, which is considered a reliable, practical and inexpensive tool, in the diagnosis of acute appendicitis, and whether it can be an alternative to ultrasonography and help reduce the negative laparotomy rates. Methods: A total of 327 patients, who were referred to İstanbul Haseki Research and Training Hospital General Surgery Clinic for abdominal pain and who received the diagnosis of acute appendicitis using both compression ultrasonography and Alvarado scoring system were retrospectively evaluated. Results: Two hundred and nine patients with abdominal pain and acute appendicitis were operated and 108 patients who did not require surgery were discharged after being placed in observation. The sensitivity and the specificity of the Alvarado score were found to be 92% and 28%, respectively The sensitivity and specificity of ultrasonography were 84% and 39%, respectively. Ultrasonographic findings were consistent with acute appendicitis in 180 (82.2%) of 219 operated patients, whereas appendix was normal in 39 (17.8%). Ultrasonography showed acute appendicitis in 92 (85.2%) and normal appendix in 16 (14.8%) of the 108 patients in the unoperated group. Conclusion: Alvarado score is not superior to ultrasonography in reducing negative laparatomy rates, but it can be used safely in the diagnosis of acute appendicitis andsurgical decision making.