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Value of Ultrasonography in Acute Appendicitis in Patients with Modified Alvarado Scoring System Score of 5 & 6

Authors: Ziad Ghanem Mohammed --- Mohammed Jawad Mohammed Al- Najjar --- Huda Ali Al-Hussaini --- Haider Abdulhussain --- et al.
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 277 -283
Publisher: Babylon University جامعة بابل

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Abstract

Acute appendicitis is one of the most common and challenging surgical emergencies. Ultrasound [US] is widely available , highly accurate imaging modality in patients suspected to have acute appendicitis, this study was done to assess the value of US in evaluation of suspected acute appendicitis patients with Alvarado Scoring System [MASS] of 5 & 6 . In this prospective study a total of (100) patients with clinically suspected acute appendicitis and with Alvarado score between 5 &6 underwent US examination of the abdomen The accuracy of ultrasonography in the diagnosis of appendicitis was compared with clinical diagnosis, laparotomy findings and histopathological examination reports.. The patients were divided into two groups: group A included those for whom surgery was done & the final diagnosis was established depending on the surgical finding &/or histopathology results & this group comprised (65) patients . Group B comprises patients who did not underwent surgery ,these patients were followed up until their improvement & discharge from the hospital & this group included (35) patients. The overall specificity of ultrasound was 88% and the sensitivity was 89% in the diagnosis of acute appendicitis in patients with MASS of 5 & 6 .US is a valuable tool in diagnosing acute appendicitis in patients with MASS (5 & 6). When the clinical sign and symptoms are combined with US, the diagnostic accuracy is significantly high.


Article
Accuracy of Modified Alvarado Scoring System in Early Diagnosis of Acute Appendicitis
دقة تعديل نظام تسجيل Alvarado في التشخيص المبكر لالتهاب الزائدة الدودية الحاد

Authors: Star S. Hussein --- Nadya Y. Ahmed --- Tayeb S. Kareem
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2009 Volume: 13 Issue: 2 Pages: 8-13
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and Objectives: Appendicitis is a common surgical emergency. The patients with equivocal signs can present a diagnostic challenge. Early diagnosis and intervention is mandatory for prevention of complications. On the other hand negative appendicectomy should be avoided as much as possible. The aim is to evaluate the role of the modified Alvarado scoring system in early diagnosis of acute appendicitis.Methods: During a period of 6 months from 1st February to 31st July 2008; 250 patients with right iliac fossa pain were admitted and observed in Emergency Hospital in Erbil. The age of the patients was ranged between 13-70 years (mean 22 years ). The male to female ratio was 3:2. They were prospectively evaluated on admission using modified Alvarado scoring system to determine whether or not they had acute appendicitis. The results were correlated with the operative and histopathological findings.Results: After first scoring; 179 (72%) patients were admitted and 71 (28%) patients were discharged. Rescoring by modified Alvarado scoring system was done after 6 hours from admission, only 162 (91%) patients were operated on , and the rest 17 (9%) patients were discharged. During operation we found that 142 cases (87.5%) had really acute appendicitis. Overall the modified Alvarado scoring system showed sensitivity of (93%) for [8-9] scores and (39%) for [1-7] scores. .Conclusions: The modified Alvarado scoring system is accurate in early diagnosis of acute appendicitis . Patients with 8-9 scores should be operated on immediately without hesitation. Patients with score 5-7 must be admitted and scored frequently. Score 1-4 can be discharged unless otherwise indicated.

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